The Underactive and Overactive Thyroid | Stephanie Smooke, MD, and Angela Leung, MD | UCLAMDChat

good morning I’m dr. Angela lurk and this is dr. Stephanie smoothdraw were from the segment of endocrinology at UCLA we’re so delighted that you can join us for this webinar seeing an underactive and an overactive thyroid how do these repercussion me let’s begin and for the public that’s listening and watching please ask questions on Twitter applying this hashtag that’s shown on the screen we’d be happy and we have plenty of plenty of term at the end to entertain questions this is a brief overview we’ll be extending during the course of its next thirty minutes we’ll briefly talk about what is the thyroid then we’ll remember how does it direct and then truly concentrate the bulk of our time on the under active thyroid and the overactive thyroid so very briefly what is the thyroid well the thyroid is this butterfly-shaped gland it’s located at the figurehead part of the cervix expres accurately as you see here on the slither there’s you know different contours and different people but in general it consists of a right-sided lobe a little bridge so we called the isthmus and then the left-sided lobe and what it does the thyroid is responsible for making our thyroid hormones and what our thyroid hormones need it for they actually are important for so many important things in the body they were responsible for operations in the heart in the mentality and then also in controlling muscle but also in many other body organisations as well so I’m gonna turn it over briefly to dr.Smoot Prague for the next portion Thank You Angela so the next thing that we’re gonna go over is a little bit about how the thyroid studies and this can be kind of tricky because sometimes it’s counterintuitive as to what we may think but the thyroid is really under control of the pituitary gland which is the hormone control center that sits right in the middle of the brain and it’s the pituitary glands profession is to produce a hormone called TSH or thyroid stimulating hormone that acts on that little butterfly-shaped gland that Angela just talked about on the breast of the cervix in order to stimulate it to produce two hormones and those hormones are t4 and t3 t4 is a longer acting thyroid hormone and it’s about 80% of what’s produced by the gland and t3 is a much shorter acting hormone and it’s about 20 to 25% of what’s grown and out in the body t4 changes into t3 and that t3 becomes out and does the work of the thyroid now in order to regulate itself the t4 and t3 feed back to the pituitary in order to maintain the TSH in a ordinary reach which is considered to be between 0.5 and 4.5 now sometimes those systems don’t work properly and in hyperthyroidism we can get an overproduction of t4 and t3 and that has negative feedback at high levels of the pituitary gland and causes the TSH to go down so this is sometimes a little bit tricky but an overactive thyroid leads to a low-pitched TSH on the other hand in hypothyroidism we have a condition where we don’t have quite enough of these hormones and we’re gonna talk more about the above reasons for that and in that case those hormones communicate back to the pituitary and they stimulate the TSH to go up in an effort to produce more hormone so in hypothyroidism the under active copy we have a high TSH now how do we evaluate how the thyroid is working well your doctor will take a history from you focusing in on some of the systems that are affected by the thyroid they’ll do a physical examination and then order blood tests in terms of the history your doctor is going to focus in on body systems and symptoms that might be produced by the systems that are impacted by thyroid part so some of those include your energy positions your bowel run metabolism the mode that your organization is smelling 10 I’m feeling and in women your menstrual cycle on the physical examination your physician will focus in on vital signs including blood pressure and heart rate they will examine your thyroid they’ll take a look at your surface your reflexes and assess you for any swelling in terms of laboratory tests which ones is your doctor going to check for most thyroid measures they’re going to do a TSH and we’ll talk a little bit more about why that’s such an important test and then they may check free or total t3 or t4 hormones now why is TSH the test that we start with TSH is thought to be our optimal screening measure because there’s what’s called a negative enter linear relationship between t4 and TSH and what that entails is that really small changes in t4 hormones can lead to large-scale wavers in TSH so TSH renders us new ideas when things are happening in the thyroid even though they are they’re just a little off from regular so that it gives you a little bit of information about what the thyroid is and how it cultivates and now we’re gonna move into a little bit of discussion about that under active thyroid gland so again we come back to our chart where we see the pituitary grow the TSH that is acting on the thyroid the thyroid causes hormone and then the pituitary is interpreting what it smells and again in low levels of t4 and t3 there’ s positive feedback at the level of the pituitary and the TSH is going to elevate so what are some of the causes of thyroid dysfunction well these can be split up into “whats called” primary causes and secondary movements primary generates are things that impact the thyroid itself secondary crusades are things that impact the systems that are controlling the thyroid namely the hypothalamus and the pituitary so some problems that it can occur with the body of the thyroid itself include an autoimmune process announced Hashimoto’s thyroiditis it can occur if you’ve had surgery to remove part or all of your thyroid it can occur after therapy with radioactive iodine and then there are also congenital campaigns or things that you’re born with that can impact the function of the thyroid there can also be problems with production of thyroid hormone and those can include things like iodine shortfall or enzyme flaws again that somebody could be born with or it could be impacted by different doses that you’re taking to treat other conditions in terms of secondary induces that can impact the thyroid that involves decreases in secretion of either trh which comes from the hypothalamus or TSH which comes from the pituitary at high levels of the hypothalamus there can be tumors such as lymphomas or German Ouma’s there can be infiltrative disorders such as sarcoidosis hemochromatosis or histiocytosis among others and at high levels of the pituitary again there can be tumors or mass lesions we could have dysfunction in patients who have undergone pituitary surgery or a radiation therapy and there’s a condition of hemorrhagic convulsion which signifies bleeding into the thyroid gland announced Sheehan syndrome or an entity announced lymphocytic hypothesis which is an inflammation of the stalk over which the hormones cros in and out of the pituitary so what might you feel if your thyroid is not functioning well some people have lots of evidences some people find that they don’t have any evidences when they’re diagnosed with a thyroid topic but the manifestations that you might feel could include heavines gain a feeling of being more sensitive to cold or cold intolerance a slower heart rate more sluggish bowels a decrease in energy maybe a decrease in your humor people might also experience some the changing nature of their mane and hair loss maids might notice that their ages aren’t as regular or that they’re experiencing difficulties going pregnant or maintaining a pregnancy and some people might develop manifestations of carpal tunnel syndrome in terms of mansions on physical examination you might have drier coarser skin you might experience some puffiness of your face mitts or feet there might be what we call pretibial concoction edema which is a non opposing edema again hair loss some brittleness and your tacks some patients might have bradycardia or a slower heart rate and they could have diastolic hypertension which is an promoted lowered figure on your blood pressure some cases may have some slower loosening of your reflexes and on the thyroid interrogation we might see that the thyroid is normal it could be bigger than usual or it could be smaller than normal so once medical doctors has examined your history and gone through your physical examination the next thing that they’ll do for diagnosis is some laboratory testing and again we start with that TSH level because it is the most sensitive number in terms of shifting thyroid hormone in your figure an additional testing might include a free t4 level and tests for thyroid antibodies in order to diagnose Hashimoto’s thyroiditis and finally your exam may or may not include a thyroid ultrasound depending on what your doctor has noted on physical examination so question that we’re frequently asked is what do positive antibodies want and positive antibodies could be a thyroid peroxidase antibody or a thyroid globulin antibody and those characterize Hashimoto’s thyroiditis and what that is is it’s a condition wherein antibodies again exist against the thyroid that may impact thyroid gathering over occasion some cases might even have a little short term hyperthyroidism followed by either normal thyroid affair or low thyroid office but the important thing to remember is that the number of people with Hashimoto’s antibodies far outstrips the number of people who actually have low-grade thyroid perform so even though they are you’ve been diagnosed with antibodies your thyroid may still continue to function normally once you’ve been diagnosed with low-pitched thyroid operate the next step is management and our goal in medication is to normalize thyroid hormone ranks to alleviate signals and evidences of hypothyroidism we do this with several different types of medication and I’m going to talk about two major characters today the first involves t4 and again that t4 is a replica of what your thyroid is not able to produce well enough on its own and it’s quite a long lasting hormone so when your remedy reachings a continuous government in your form it’s going to hang around for about 7 days now there are a bunch of different types of these medications and I’m going to show you here we have some of the generic drugs like levothyroxine and labelled medications are leaveth roid synthroid and livox’ el and all of these gathering very similarly in your figure you might find that there could be little variations in how your torso is absorbing them or how they’re impacting your thyroid evaluations so if you’re switching back and forth from one to another your doctor might want to check your thyroid elevations after a modify the other medication that we have listed here is Tyra –scent and this is a newer medication that we found to be somewhat effective in patients who have history of celiac ailment so they have an allergy to gluten or they have lactose intolerance because this medication doesn’t contain any celiac concoctions or lactose you might have also heard about another set of medications which are t3 remedies and again this is the hormone that is produced in a smaller amount by the thyroid gland and also is proselytized from t4 in your organization and when you’re make this the half-life of this prescription or how long it lasts in your torso is much shorter so you might have to make this remedy every eight hours in order to maintain a continuous commonwealth the generic constitute of this prescription is called lieth Iranian and the firebrand that you might have seen is called site ml now after starting remedy your physician will recheck your blood work anywhere from about eight to twelve weeks after a modify and there can take a little bit of duration before the TSH catches up with your degree of management now that other important thing to remember is that the thyroid prescriptions are a little bit finicky so we want to make sure that we’re taking them properly in order to ensure that they’re going to have their best efficacy so what we recommend is that you take your remedy on an empty tummy and that can either be 30 to 60 minutes before devouring or well 3 to 4 hours after eating so you should discuss with your doctor whether you’re planning on taking them in the morning or whether you would prefer to take them at bedtime the other thing to remember is that there are some substances in the body that can impact how your medication is absorbed and those include calcium iron fiber multivitamins and soy products and if you’re do augments that contain any of those entities it’s preferred to make them about a four hour distance away from your thyroid medication now one of the questions that were asked routinely is what if my thyroid degrees are normal that I’m still having symptoms and this is probably one of the tougher things that we confront when we’re trying to help our patients and in this case we have to remember that in order to blame things on the thyroid our evidences genuinely have to match up with our thyroid levels so if you’re having symptoms that looks a lot like thyroid evidences but the levels are normal then the next step is for you and your specialist to work through and see if you can come up with other reasons that that may be happening so to finish up on hypothyroidism merely a remember that hypothyroidism is a state of having an underactive thyroid that doesn’t form fairly hormone the diagnosis is represented based on history of physical exam and laboratory testing and the medicine of hypothyroidism involves taking medication that replaces what the thyroid is not able to do on its own so with that I’m now going to hand back over to Angela for a discussion of the overactive all right so we’re gonna switch gears completely and move to the situation of what happens when the body is actually concluding method too much thyroid hormone in contrast to wait too little so hyperthyroidism is that and it again is when the thyroid is overactive too much thyroid hormone is being made and as a result as you can imagine every sort of body system is revved up everything speeds up because metabolism is increased and the body actually fatigues quite easily as a result it’s unable to compensate typically and why are we concerned about having too much thyroid hormone why can’t we really have sort of this increased metabolism and this increased state of being revved up well it’s more of areas of concern over the long term if you have a little bit of excess thyroid hormone the main concern are bad effects of having too much thyroid hormone on the heart and parties with this situation can develop sort of a scooting heart rate the heart is sort of pushed too fast you can develop arrhythmias and then secondarily you can also have weakened bones or bone loss because there’s too much metabolism and this can result in something announced osteoporosis now what are the evidences of hyperthyroidism or having too much thyroid hormone it’s as you can expect it’s the opposite of hypothyroidism so in contrast you would have too much energy the person might feel some nervousnes they might have weight loss that is unintentional as we spoke of previously your heart rate can be very very fast a sort of a scooting heart rate is what’s just described your stools can be very loose or you are eligible to have diarrhea you’re easily sweaty your fuzz can be easy to fall out this feeling of being red-hot all the time is very very common in addition on exam you might have some shakiness or trembles that you can’t ascertain trouble sleeping as a result of that and your skin is always very warm and moist and it we’ll talk a little bit about one particular type of hyperthyroidism in the next few moves but in this particular type of hyper Aaron is amazed some people can actually have their sight changed as well and so this might reveal and the symptoms of red looks or bulgy bigger eyes the feeling of grittiness like that’s your eyes are always exceedingly awfully itchy or you can have some double dream so causes of hyperthyroidism let’s go through those by far the most common cause of hyperthyroidism is something announced Graves disease record for at least 70% of all causes and it really is an autoimmune disease with which the entire thyroid gland makes a little bit too much thyroid hormone in differ the second probably the most common cause is something called toxic thyroid nodules and there’s many many other appoints for lethal thyroid nodules sometimes they’re announced hot nodules or autonomous nodules and it’s different situations in contrast to Graves disease in which the entire gland builds too much thyroid hormone in poisonous thyroid nodules only one particular part and something called a little bump or romance mingle that is responsible for making too much thyroid hormone and you are eligible to have more than one nodule in any one gland but this is just an example of one nodule other causes of hyperthyroidism you can have some swelling of the thyroid and this is known as thyroiditis usually this is temporary which you know the thyroid is inflamed from many many different causes and it does self resolved but in some times it does stay and hang around and this results from leakage usually of preformed pirate hormone so the thyroid have now been obliged its collect of hormone but for some reason there’s a lot of rednes and out holes the the preform accumulates now these a little bit these causes of hyperthyroidism or a little bit more rare but they’re actually not uncommon lessee and one of them is access iodine exposure we didn’t talk a little about what iodine does but it essentially is a substrate it’s required for drawing thyroid hormone in the body chiefly the source of iodine is through the food but sometimes we’re exposed through other things sort of in prescription that contain a lot of iodine things like I needed cat scans or cardiac catheterizations and these things are very necessary for imaging that you might require for other questions but as a result that excess exposure to a good deal of iodine all at once misses the thyroid to abruptly make access the thyroid hormone iodine is also naturally found in kelp or people can find it in iodine augments and this poses an increased risk for developing hyperthyroidism for the same reason and there are also some smaller lawsuits that are much more rare but they’re also possible and if the preceding four compels don’t seem to sort of make sense between you and your physician or physician might explore some of these other causes as well so I wanted to concentrate a little bit on Graves disease exactly because it is by far the most common cause of hyperthyroidism it actually is the most common cause both in the u.s.Also but worldwide now and what it is it is an autoimmune disease in which there antibodies which are set forth in the bloodstream and these you know to travel and clusters in certain family and what they do indicated in the green in the sketch is that they sort of stimulate the thyroid cadres to sort of turn on the thyroid in a everlasting country to reach excess thyroid hormone all the time so with all other autoimmune maladies autoimmune cancers tend to travel together so you or family members might also note a autobiography of other infections sort of more frequently than the general population things like sort 1 diabetes or celiac ailment Addison’s cancer which is a disease of the adrenal or vitiligo which has whiteness of the surface hypo pigmentation now noticing indicative of Graves disease because it is an autoimmune illnes it’s a little more special regularly kinfolks might complain and present with an enlarged thyroid this is an extreme example that I’ve shown here in the picture but this is something that we called a thyroid quarter again folks might have eye disease that’s involved in Graves disease and it’s result of those antibodies are arousing Bokke thyroid as well as the eye so you might have those those attention indications that I spoke about previously if the perfusion the bulgy noses the itchy noses so far and then your doctor might also be asking about the fact that there are other autoimmune diseases either in yourself or a close family member now speaking a little more about Graves eye disease this is also known as Graves off the mapa the– and again it’s a very specific sign and manifestation of Graves disease itself not everyone with Graves disease will have this thyroid nose illnes exclusively a smaller percentage of them folks will but these are the manifestations again and these are some some more severe photos of what Graves automata coagulated look like I’m interestingly graves ophthalmopathy or thyroid nose ailment this is actually worsened by cigarette smoking so oftentimes if we find that Graves disease is present in you we admonish “youre going to” either stop smoking or at least decrease the amounts of cigarettes use and then folks with very severe or even moderate extent of thyroid eye illnes we can easily refer you to our colleagues who specialize in thyroid attention ailment now there’s a special type of consideration for Graves disease and pregnancy and this is because there’s high risks of complications both when you deliver the baby but likewise for the newborn following the birth if “youve had” Graves disease during pregnancy that’s uncontrolled these are some of the complications that can happen at the time of delivery so miscarriage preterm labor and burp your baby can be born with lower birth weights Silber or something called preeclampsia which includes high blood pressure in the mother during pregnancy and because there are some special ramifications for protecting your baby after bringing but too at the time of delivery you should talk about therapy possible options for groups disease if you are intending on becoming pregnant in the future or currently pregnant because those have some different connections and what we’ll do and then if definitely “youve had” Graves disease and you are pregnant your doctor will work closely with you to make sure that the child is healthy as possible during the course of pregnancy okay so how is hyperthyroidism or extravagance thyroid hormone diagnosed we make love with a combination of blood testing and sometimes imaging principally goes we do use imaging in such a situation and this can include a thyroid ultrasound and if I read nuclear scan and uptake I’ll talk a little bit more about what those are in just a bit so laboratory testing firstly just like hypothyroidism the initial blood research that we always do is something called a t-shi thyroid quickening hormone and this will be low in hyperthyroidism just like dr.Smith impart off about but there are certain situations that can also lower the TSH so that’s actually needs to be tantalized at between you and position to make sure this is really a genuine cause of hyperthyroidism if the TSH is found to be low we might do some confirmatory assessments with measurement of the t3 and t4 that was previously discussed and those should be high and then if we’re suspecting an autoimmune form of hyperthyroidism like the Graves we might actually check and quantity those thyroid hormone thyroid antibodies in the blood stream and those can include tpo or thyroid peroxidase antibody and thyroid stimulating immunoglobulin or TSI now for portrait the first and easiest sort of imaging that we can do and usually right at the part in the same visit is a thyroid ultrasound it’s using a extremely non-invasive immediate painless probe that you verify on the on your left to obtain this picture that you see here on the right and again we can see very easily the title lobe of the thyroid that little connect called the Isthmus and that left lobe to picture precisely sort of what is going on if that’s not able to with combination of blood testing able to arrive at a diagnosis of why you have hyperthyroidism we might consider and recommend something called a nuclear and an uptake it’s pretty helpful for figuring out why you have hyperthyroidism because it’s able to narrow down a lot of different campaigns very very quickly however it’s a kind of a different experiment you can’t do it right there in your office visit that you at the time you see your endocrinologist you’d have to make an appointment to see a radiologist it’s at that appointment you are able to take a little small pill with radioactive iodine a very very small tracer dose and then either four hours and maybe 24 hours later you would come back and take a word-painting to Ixia Gyarados went and traveled in your thyroid oh okay so now that we’ve diagnosed hyperthyroidism let me review briefly about how we treat hyperthyroidism there is sort of three major areas let me go back to this one so this is lozenges and these are just essentially drug they’re very very effective to slow down the rate of thyroid hormone creation come your thyroid gland the specimen that we have here in the US are methimazole and purple Thyer uracil also known as PTU if parties make these prescriptions for something announced Graves disease that most common figure of hyperthyroidism you can achieve remission which means that your disease is now verified and you can stop the medication in about twenty to thirty percentage of the time nonetheless these prescriptions do have specific risks like any medications do and because of that we only recommend that they be taken for a maximum of about one to two years so 18 to 24 months is what’s recommended these are some of the side effects that can be seen rash actually is fairly common but it’s minor and if it’s tolerable it may go away more seriously there could be Liberty image this third part the low-toned white blood cell count is very very rare but if it happens apparently that’s impacting your immune method and that can be very dangerous because of that when people stop start these drugs myth cruise missiles and purple ardour uracil we councilman patients to immediately stop the medication if you have a high high fever or the worst sore throat of their own lives that was noted that perhaps your immune arrangement might be affected and then again if you’re planning on becoming pregnant while you’re take such prescriptions it’s important to discuss this point with your doctor for them to counsel you on specific shows for taking particular drugs next we have something called a radioactive iodine medication and this is essentially a capsule it’s a radiation pill I 131 and here’s an image of what an nose 131 pill might look like it’s taken orally in conjunction with a nuclear drug physician and over the course of the next several months that radioactivity gradually kills off the thyroid gland that’s originating the excess thyroid hormone it’s not very fast it’s not very immediate but over the course of several months it can take effect to lower your quantities of thyroid hormone because it is radiation there’s some safety precautions that are required in the first few days especially after you take this capsule and so there’s some isolation procedures that we can counsel folks on for the first sort of three to five days after you make this lozenge to not be around other kinfolks and exposed their thyroids to this radiation there’s some potential long-term effects of radioactive iodine the latter are controversial but you know sometimes we give you and plow you with the radioactive iodine to result in actually an underactive thyroid because enough thyroid cells are killed permanently to not perform the plethora thyroid hormone but this results in an underactive thyroid and also it’s a little bit more controversial but some tribes think that this little bit of radioactivity even though it’s very very small and it’s targeted just for the thyroid can result in another cancer sometime down the road in your life and then the third type of treatment is thyroid surgery this is usually reserved for tribes who flunk either the medications because they can’t tolerate the prescriptions or for some reason they can’t do the radioactive iodine it’s best performed under a Center by a surgeon with substantial suffer in the thyroid because there’s potential damage to the parathyroid glands which are located very close to the thyroid and the parathyroid glands control the way the body employs calcium secondarily there can also be damage to the vocal cords which restrain your spokesperson so potential complication of thyroid surgery might be hoarseness however in a very good center done with a surgeon who does a good deal of these thyroid surgeries the chance of both of these complications happening is often less than 1% and then patently if thyroid surgery is play-act the point is to take out your thyroid remove the source of the thyroid hormone excess this will result in permanent hypothyroidism not having enough thyroid hormone and again you would have to take tyroid hormone pill every day for the rest of your life ok so in summary that medication percentage the initial recommendation of which of the three types of treatment genuinely depend on so many causes and you should discuss this with your physician it depends on your age it depends on what the cause of the hyperthyroidism is how severe your hyperthyroidism is at the present time other medical conditions which might be present including pregnancy or scheduled maternity in the near future and then your personal wish so almost at the end but I wanted to give this one little dainty which is such a neat little information that hyperthyroidism or an overactive thyroid gland is actually the most common form of an endocrine illnes in the bag of cats and your pussies so you very well might have cats who are taking methimazole or purple tiger or so in the same fashion and so so in summary for hyperthyroidism it’s a state of having too much thyroid hormone an overactive thyroid the most common cause for hyperthyroidism at about 70% of the time is something called Graves disease it’s an autoimmune infection the diagnosis of hyperthyroidism is made by a combination of the laboratory blood tests and then if needed some imaging and the medicine are three alternatives either remedy capsules radioactive iodine or thyroid surgery so thank you so much for listening we’re happy to take any questions that you fed in through Twitter and I’ll hand it over to dr.Smith probably might have a few questions previously lined up so we have some excellent questions that have come in via the Twitter feed and one of them is asking about someone whose mother has thyroid problems and she’s often feeling tired and having a sense of wearines and the person wants to know when should she be worried and can her primary care physician take care of the screening and that’s a great question and the answer is absolutely primary care physicians can take care of the screening for thyroid illness and if your family member has a history of thyroid issues and they’re starting to develop some symptoms of either low-pitched thyroid gathering which are again things like feeling freezing and constipated and tired and more sluggish or feelings of overactive thyroid that we just learned about like feeling too warm or anxious and having the heart race and the bowels be too loose the first step is to go into your primary care physician and have that TSH screened and if your primary care physician feels cozy they can go ahead and manage and if not they’ll refer you on to an endocrinologist for further evaluation another great question that we have on here is are there any exercisings or life-style demeanor that you should adopt if you have hyperthyroidism or overactive thyroid and this is a great question because as “weve learned” fibroid hormones have an impact on muscle so if you are in an active commonwealth of hyperthyroidism and you haven’t been adequately plowed yet your doctor will probably recommend that you not do any energetic workout until the thyroid serve is more nor and that’s because of the fee that it can take on your mas and your muscles so if you were to exercise when your thyroid capacity is overactive you can actually have some failure of the muscle proteins which can in turn unfortunately start some problems for the kidneys very good there are some questions about the risk of radioactive iodine and beginning another cancer or sometime down the road and so we talked a little bit about what radioactive iodine is it is radiation but because it’s tied to an iodine molecule the only role of iodine in the entire body so nicely is actually to go to only thyroid material so because it’s bind this radiation to iodine it should really just target the thyroid gland and zapping apart that excess thyroid hormone but as you can imagine radiation does sort of have a tendency to spread elsewhere most of it is extruded and come rid of from the body through the bodily fluid so your sweat your saliva your sobbings your your in in the first few days and the highest proportion of it does remain often it should just remain in the thyroid gland but they’ve done some large long-term studies and the risk of having a second cancer is potentially they’re a little bit controversial but if we had to choose the types of cancer that you might have it somewhat high risks for it would be the blood types of cancer so the leukemias these are incredibly uncommon room less than 1% for certain but you know this is something that is continue to be debated and continues its work researched on so great question another question that someone has sent in is what are some of the best ways to prevent hyperthyroidism or hypothyroidism this is actually a moderately common question and predominantly because you know so much of thyroid dysfunction thyroid illnes it has an autoimmune nature so some people sort of wonder is there something I can do to prevent or at least decrease the amount of autoimmunity I have well first of all as dr.Smith Pro had said a lot of people have these thyroid antibodies that are really not affecting the thyroid operate so something called Hashimoto’s thyroiditis it exists in about 15% of the general population so if you do the math that’s one in six people who have these thyroid antibodies that on the most part are really not affecting you but if “youve had” these thyroid antibodies at this present time we actually don’t know what progresses a certain person from having the antibodies to having an underactive or an overactive thyroid so it’s not really something that you can sort of proactively do to prevent the onslaught of this cancer what we can do is follow you very closely and use it right medications in order to prevent the long term consequences terribly very common question but I’m sorry I don’t have a sort of a more of a concrete answer to that Oh perfect yeah yeah this is a great segue into iodine so one of the questions that we get frequently asked is should I be taking an iodine supplement in order to support my thyroid and it’s a little bit tricky because our body needs a certain amount of iodine in order to keep everything functioning the way that it should but if you do have Hashimoto’s thyroiditis taking too much iodine can actually shut down your thyroid so by do assist augments or iodine adds-on or some of the thyroid supporting complements that you recognize at the pharmacy those could come in your road more than helping you in maternity our mas requires a little bit more iodine so you want to check the labels in your prenatal vitamins and make sure that you’re getting adequate daily dosing we have a couple slithers regarding this again iodine is essential for a thyroid hormone make and so both too much or too little iodine can actually shut down the thyroid and do you have thyroid dysfunctions that’s not a good doctrine but I wanted to show you the recommendations for iodine intake if you’re not pregnant so this is sort of normal your regular non-pregnant not breastfeeding adult 150 micrograms if you are pregnant or breastfeeding the babe that’s growing inside of you or has just been delivered requires a little bit of iodine for themselves as well because their thyroid is still not functional so these are the recommendations 220 micrograms a day for pregnant women 290 for lactating women and then in children these are the recommendations a little bit less but 90 to 120 and a ordinary diet truly should have enough but if you are pregnant or lactating specially since the newborn doesn’t have their own thyroid hitherto and there was a need for fairly thyroid hormone for their brain function truly you should have enough there and there are many multivitamins that contain various extents that you can go around and shop for so with that we want to thank everybody for their attending we hope that you’ve learned a little bit about fibroid capacity and both the under active and overactive thyroid glands have a good day