Category Archives: Disease

Symptoms of Hypothyroidism

Symptoms of Hypothyroidism

A medical student checking blood pressure usin...
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Hypothyroidism usually develops slowly and early symptoms can be very mild to imperceptible. Many symptoms are at first brushed aside as a normal part of the ageing process. However when such symptoms group together or become more severe, it’s time to make notes about them and go see your doctor and request a blood test.

Signs of hypothyroidism indicate that the body is shutting down and not coping. They include the following symptoms:

Early Signs

Dry, itchy, scaly skin
Thin, brittle fingernails
Dry coarse hair,

Sore eyes, blurred vision
Puffiness around or sunken eyes

Sleep disturbances

Increased sensitivity to cold
Decreased perspiration

Constipation

Slowed speech and movements
Lethargy, apathy, no energy

Depression, broody thoughts
Forgetfulness, impaired memory
Confusion, unable to concentrate

Fatigue, sleepiness

Muscle cramps,
Muscle tension, tightness
Poor muscle tone (hypotonia)
Joint pain

Weight gain and water retention

 

Symptoms more specific to Hashimoto thyroiditis:

Feeling of fullness in the throat

Painless thyroid enlargement

Exhaustion

Neck pain, sore throat, or both

Low-grade fever

Later Signs

Goiter

Elevated serum cholesterol

Anaemia caused by impaired haemoglobin synthesis (decreased EPO), impaired intestinal iron and folate absorption or B12 deficiency from pernicious anemia

Slow speech and a hoarse, breaking voice – deepening of the voice can also be noticed, caused by Reinke’s Edema.

Dry puffy skin, esp of face
Increase in Hair loss
Thinning of the outer third of the eyebrows (sign of Hertoghe)

Abnormal menstrual cycles
Fertility problems

Thyroid-Related Depression
Irritability and mood instability

Dull facial expression
Coarse facial features

Sluggish reflexes
Weakness in the extremities

Bradycardia (slow heart rate – pulse – fewer than sixty beats per minute)

Blood pressure – Decreased systolic blood pressure and increased diastolic blood pressure

Low basal body temperature

Increased need for sleep

Shortness of breath with a shallow and slow respiratory pattern

Less Common Signs

Puffy face, hands and feet
Pericardial effusion (fluid around the heart)
Abdominal distension, ascites
Nonpitting edema (myxedema)
Pitting edema of lower extremities
Hyporeflexia with delayed relaxation, ataxia, or both

Paresthesia and nerve entrapment syndromes (eg Carpal Tunnel Syndrome)

Hyperprolactinemia  Galactorrhea
Gynecomastia

Decreased hearing, deafness

Decreased libido in men due to impairment of testicular testosterone synthesis

Decreased sense of taste and smell (anosmia)Difficulty swallowing

Impaired memory
Impaired cognitive function (brain fog) and inattentiveness.

A slow heart rate with ECG changes including low voltage signals. Diminished cardiac output and decreased contractility

Reactive (or post-prandial) hypoglycemia

Yellowing of the skin due to impaired conversion of beta-carotene to vitamin A (carotoderma)

Impaired renal function with decreased glomerular filtration rate

Acute psychosis (myxedema madness) (a rare presentation of hypothyroidism)

Macroglossia ( Enlarged tongue)

Some people with hyperthyroidism will have few and others will have many symptoms – each person is different. Also – groups of these symptoms may be caused by something else entirely and not indicative of hyperthyroidism. Help your doctor by keeping a note of all your own symptoms and ask their opinion. S/he will send you for blood tests and find out what’s going on.

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What is Hypothyroidism?

What is Hypothyroidism?

The pituitary gland and hypothalamus both control the thyroid. When thyroid hormone levels drop, the hypothalamus secretes TSH Releasing Hormone (TRH), which alerts the pituitary to produce thyroid stimulating hormone (TSH).

The major endocrine glands of the body. Pituit...
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The thyroid keeps your metabolism under control with thyroid hormone, which it makes by extracting iodine from the blood.

Every cell in your body depends on the thyroid to manage its metabolism.

Hypothyroidism occurs when the thyroid fails to make enough of these hormones.

When the thyroid gland is unable to produce sufficient amounts of  thyroxine (T4) and tri-iodothyronine (T3) then problems start to occur in all of the body’s systems as the normal bodily functions start to slow down.

All the body hormones work together, so that changes in one effect others. When our body is young this generally works like a well oiled machine. When we pass middle age, the changes affect us more.

This is a possible reason why more women than men appear to be affected by hyperthyroidism especially after they turn 50.

There are three types of hypothyroidism.

The most common is primary hypothyroidism, in which the thyroid gland itself becomes diseased and fails to produce sufficient amounts of the thyroid hormone. The most common forms include Hashimoto’s thyroiditis (an autoimmune disease) and radioiodine therapy for hyperthyroidism.

Secondary hypothyroidism is caused by problems with the pituitary gland and accounts for less than 5-10% of hypothyroidism disorders. It occurs if the pituitary gland does not create enough thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce the required amount of thyroxine and triiodothyronine. It is usually caused by damage to the pituitary gland, as by a tumor, radiation, or surgery.

Tertiary hypothyroidism results when the hypothalamus fails to produce sufficient thyrotropin releasing hormone (TRH). TRH prompts the pituitary gland to produce thyroid-stimulating hormone (TSH). Hence tertiary may also be termed hypothalamic-pituitary-axis hypothyroidism. It accounts for less than 5% of hypothyroidism cases.

Patients who have hypothyroidism should exercise caution with certain activities, especially if an activity has a risk of injury (eg, operating presses or heavy equipment, driving, heavy physical labour and contact sports. If their treatment is not yet stabilised and they are having difficulty maintaining concentration in low-stimulus activities, they may have slowed reaction times.

They may also be at risk for ligamental injury, particularly from excessive force across joints due to generalized hypotonia. Hypotonia is a state of low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength.

Hypothyroidism may be linked to other autoimmune diseases, such as Addisons disease, Chronic Fatigue Syndrome, Diabetes Mellitus, Euthyroid Sick Syndrome, Fibromyalgia, Lupus, Polyglandular Autoimmune Syndrome & Vitiligo.

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Thyroid

Your Thyroid Manages Your Metabolism

Front view of neck.
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The thyroid is a butterfly shaped gland at the front of the throat just below the Adam’s apple. Our thyroid gland regulates our Metabolism and is responsible for creating hormones that drive several metabolic systems including our growth, both physical and mental, and our energy stores.

Around one in 20 people will experience some form of thyroid dysfunction (either overactive or underactive) in their life. Thyroid problems tend to affect a larger percentage of women more than men and the risk of thyroid dysfunction increases as you age.

Your metabolism is your body’s ability to break down food and convert it to energy. Food is like fuel for our bodies and each person uses it at a different rate. This is why you often hear about some people having  a fast or a slow metabolism.

Metabolism is determined by measuring the amount of oxygen used by the body over a specific amount of time. If the measurement is made at rest, it is known as the basal metabolic rate (BMR).

Differences in BMRs are associated with changes in energy balance. Energy balance reflects the difference between the amount of calories one eats and the amount of calories the body uses. A negative energy balance may lead to weight loss as occurs with hyperthyroidism. The BMR in a person with hypothyroidism is decreased, so an underactive thyroid is generally associated with some weight gain.

Measurement of the BMR was one of the earliest tests used to assess  thyroid dysfunction. Patients whose thyroid glands were underactive (hypo) were found to have low BMRs, and those with overactive (hyper) thyroid glands had high BMRs.

Hyper Or Hypo Thyroidism?

If you have Hyperthyroidism when your thyroid produces too much thyroid hormone, you may feel wired, anxious and impatient, you may also be prone to sweating and a pounding heart.

If you have Hypothyroidism when your thyroid hormone production is insufficient, you will feel the cold, get tired easily, feel slow, think slow and have insufficient energy to tackle things.

Diagnosis and Measurement of Thyroid function

Thyroid dysfunction is diagnosed after blood tests are taken and may be treated with drugs or sometimes surgery. An overactive thyroid may be suppressed by taking a specific drug. An underactive thyroid is generally treated with a supplement of thyroid hormone. The patients doctor will order blood tests every 6 weeks to three months until the right dose is settled on. Blood pressure, pulse rate and body temperature are simple checks that people can make to chart their treatment progress themselves.

If you have had tests done and need help to decipher them check out Optimal Lab Values

This info is a bit simplistic. Different types of thyroid disease will require different treatments. The thyroid gland may be damaged in many different ways, so you will need to look for websites with comprehensive Thyroid information that is specific to your personal diagnosis. The following 2 websites  gives simple easy to understand information.

Endocrine Web information on thyroid dysfunctions.

Web MD info on thyroid dysfunction

 

 

 

 

 

 

 

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Equivalent Thyroid Hormone Brand For Australia

Thyroid Hormone Brands

(Article republished from the Australian Thyroid Website – see credit below)

Every day millions of Americans take a small pill to compensate for a lack of thyroid hormone in their bloodstream. The drug of choice for the treatment of this and other thyroid disorders is synthetic levothyroxine sodium. The American Druggist listed two brand-name preparations as the 3rd and 51st most prescribed drugs in the United States during 1996, accounting for over 36,000,000 prescriptions of synthetic levothyroxine last year. Physicians and scientists may use different scientific names for levothyroxine, such as L-thyroxine, thyroxine, and T4 ; however, all of these terms refer to the same chemical. Thyroid hormone replacement with synthetic levothyroxine is safe, simple, effective, and relatively inexpensive.

THYROID HORMONE PREPARATIONS
UNITED STATES
BRAND-NAME LEVOTHYROXINE
Euthyrox®
Levothroid®
Levoxyl®
Synthroid®
GENERIC LEVOTHYROXINE
levothyroxine sodium USP
L-thyroxine
DESICCATED ANIMAL (“natural”) T4 /T3
Armour®
SYNTHETIC T4 /T3
Thyrolar®
SYNTHETIC T3
Cytomel®
AUSTRALIA
BRAND-NAME LEVOTHYROXINE
Oroxine®
Eutroxsig®
GENERIC LEVOTHYROXINE
DESICCATED ANIMAL (“natural”) T4 /T3
Dartnells Pharmacy
Stenlake Pharmacy
SYNTHETIC T4 /T3
SYNTHETIC T3
Tertroxin®

History of Thyroid Hormone Replacement

From the late 1890’s until relatively recently, physicians worldwide have treated hypothyroid patients with tablets containing desiccated (dried and powdered) animal thyroid glands. These tablets contained both levothyroxine (T4) and triiodothyronine (T3). In 1958, the first synthetic levothyroxine tablets were marketed in the United States. Because thyroid hormones were on the market before the Food and Drug Administration (FDA) laws were in place, manufacturers of these hormones were not required to meet the extensive testing requirements of safety and effectiveness required of all new drugs introduced after 1938. In other words, thyroid hormone replacements, such as synthetic levothyroxine, were “grandfathered” into the system; consequently, there are no FDA approved procedures or standards for testing these preparations other than specifying that each pill contain between 90% to 110% of the stated chemical content.

Who Needs It?

The majority of patients taking levothyroxine have a permanent form of hypothyroidism and will take one pill, every day, for the rest of their lives. The causes of permanent hypothyroidism are listed below:

  • Hashimoto’s thyroiditis (a chronic inflammation of the thyroid gland)
  • Radioactive iodine treatment for hyperthyroidism
  • Surgical removal of part or all of the thyroid gland
  • Congenital abnormalities, including an absence of the thyroid gland
  • Iodine deficiency
  • Radiation for cancers, such as Hodgkin’s disease
  • Pituitary or hypothalamic dysfunction
  • Unknown causes (idiopathic)

Levothyroxine therapy may also be indicated for patients with goiter, solitary thyroid nodule, multinodular goiter, thyroid cancer, thyroiditis, and hyperthyroidism treated with antithyroid drugs. In addition to the thyroid disorders listed here, some physicians have found that levothyroxine can enhance the effectiveness of certain antidepressants and use it temporarily to treat depressed patients.

Thyroid Hormones in the Bloodstream

Levothyroxine (T4) and triiodothyronine (T3) are the thyroid hormones that circulate throughout the bloodstream. The thyroid gland is the sole source of T4 . However, only 10% to 20% of T3 is made in the thyroid gland; the remaining 80% to 90% is produced when T4 is broken down into T3 by other organs in the body.

When a patient takes levothyroxine, the level of T4 in the blood rises and falls slowly. On the other hand, when a patient takes medications containing the much more potent T3, the blood level of T3 rises quickly to hyperthyroid levels and falls rapidly. Therefore, preparations containing T3 cause patients to become hyperthyroid several hours a day. Substituting one disease–hyperthyroidism–for another is not desirable.

Synthetic vs. “Natural” Thyroid Hormone

Nearly everyone can take synthetic levothyroxine; it is identical to the body’s own T4 . However, some patients, thinking that “natural” means better, prefer natural thyroid hormones, which are made of desiccated animal thyroid glands. Thyroid hormones derived from animals invariably contain T3 and, as previously noted, should not be used because they can cause hyperthyroidism. Another advantage of synthetic levothyroxine is that it has a longer shelf life than natural thyroid hormones.

Brand-Name vs. Generic

There are three well-tested, brand-name levothyroxine preparations available in the United States for the treatment of thyroid patients: Levothroid®, Levoxyl®, and Synthroid®. ( By the end of this year, Euthyrox®, which is marketed in twenty-nine other countries, will become the fourth brand-name levothyroxine product to be sold here.) Although there may be differences in the manufacturing, composition (dyes and fillers), and absorption rates among these prep-arations, each of these brand-name products is reliable and offers predictable results. Although changing from one brand to another does not usually cause problems, it is preferable to take the same brand consistently.

Generic levothyroxine tablets have not been widely recommended for several reasons:

  • Scientific studies have shown that, for some generics, the T4 content of each pill can be outside the FDA range of 90% to 110% of the stated chemical content. While a 20% range may not be a significant factor for some drugs, very small amounts of thyroid hormone can make quite a difference in the treatment of thyroid patients. For example, for some patients, a 12.5% variation in levothyroxine dosage can mean the difference between hypothyroidism or euthyroidism (having the proper amount of thyroid hormone in the body). Therefore, it is essential that patients with thyroid disease take the exact amount of prescribed levothyroxine to ensure successful treatment.
  • There have been additional concerns about the quality control in the production of generic levothyroxine, especially since generic manufacturers tend to come and go in the marketplace with great frequency, making them less accountable than long-standing manufacturers of levothyroxine. The 1997 Red Book, a pharmacist’s guide to prescription generic and brand-name drugs, lists twenty-five companies distributing synthetic levothyroxine. (Some of these companies manufacture and distribute levothyroxine tablets, and others just distribute them.) Since publication, many of the listed companies are not making or selling synthetic levothyroxine.
  • From prescription to prescription, patients may be given a different generic preparation each time, making it impractical, if not impossible, to determine if retesting patients’ thyroid hormone levels is necessary.
  • While brand-name levothyroxine preparations come in eleven to twelve different strengths, generics have less variety of strengths from which to choose. Of the generic levothyroxine distri-butors listed in the Red Book, 44% have one to four strengths available; the remaining offer five to eight strengths. For patients whose levothyroxine dosage must be adjusted several times due to age or other medical conditions, it would be difficult to stay with the same product if certain incremental changes are made.

THYROID FACTOIDS
  • Synthetic levothyroxine is the treatment of choice for thyroid hormone replacement; brand-name levothyroxine is preferable to generic preparations.
  • A diagnosis of permanent hypothyroidism requires lifetime treatment with levothyroxine.
  • The average dose of prescribed levothyroxine is between 100 mcg (0.1 mg) and 125 mcg (0.125 mg); one-third of the levothyroxine prescriptions filled are for 100 mcg.
  • If the type, brand, or dosage of levothyroxine is changed, patients should have their blood levels of thyroid hormones checked two to three months later.
  • Taking more levothyroxine than prescribed does not speed up recovery and may cause hyperthyroidism and osteoporosis (thinning of the bones).
  • Taking the proper dose of levothyroxine will not increase a patient’s risk of developing osteoporosis.
  • Levothyroxine treatment is not indicated for patients with fatigue, obesity, or infertility unless the patients also have a confirmed diagnosis of hypothyroidism.
  • The warning on some non-prescription cold and flu preparations to avoid taking them if the patient has thyroid disease does not apply to hypothyroid patients taking levothyroxine in the prescribed amounts.
  • Pregnant women and nursing mothers can safely take levothyroxine. In fact, patients with inadequately treated hypothyroidism have an increased risk of miscarriage

LEVOTHYROXINE PRICES – HOUSTON
Findings of a very informal, “unscientific” survey of levothyroxine prices at four Houston pharmacies in July 1997. If you are concerned about the cost of your thyroid hormone replacement, do your own “survey” by calling several of the pharmacies in your area.
Levothyroxine
100mcg/0.1 mg
100 Tablets
Chain One Chain Two Independent
One
Independent
Two
Synthroid® $22.99 $22.49 $42.50 $33.65
Levoxyl® $9.99 $11.09 $29.00 $21.70
Levothroid® $22.99 $11.09 $26.70 $35.00
generic Levoxyl® Levoxyl® $35.00 Levoxyl®
* Pharmacy uses Levoxyl® to fill generic prescriptions.
NATIONAL COMPARISONS
Levothyroxine
100mcg/0.1 mg
Average Wholesale Price
for 100 Tablets
Synthroid® $22.70
Levothroid® $18.56
Levoxyl® $12.17
generic $3.05 to $21.45
In Australia the supply of Oroxine® is covered by the Pharaceutical Benefits Scheme and patients can expect to pay $15.00 for 200 100mcg tablets

The question of brand-name versus generic levothyroxine has never been more controversial or hotly debated than in the last year. An article in the April 25, 1996 issue of The Wall Street Journal revealed that the brand-name manufacturer who controls 84% of the levothyroxine market in the United States was trying to withhold the results of a study it had commissioned. The controversial study was eventually published in the April 16, 1997 edition of The Journal of the American Medical Association. Designed to determine whether two generic levothyroxine products and two brand-name levothyroxine products were bioequivalent, the study concluded that the four drugs tested were bioequivalent and could be used interchangeably. Since that time, scientists and physicians have debated the merits, flaws, and significance of the study. Interestingly, the two generic levothyroxine preparations used in this controversial study were actually manufactured by the same company and distributed by two other companies. Since the time of the study, one company, after switching manufacturers, has discontinued distributing levothyroxine tablets. The second company has also switched to another manufacturer and is currently distributing only one strength (25 mcg) of levothyroxine.

Where does the controversy surrounding brand-name vs. generic leave thyroid patients who depend on levothyroxine? Will physicians change their guidelines for prescribing levothyroxine? Both the American Thyroid Association (ATA) and the American Association of Clinical Endocrinologists (AACE) publish guidelines for the treatment of hypothyroidism. AACE guidelines still recommend a brand-name preparation of levothyroxine over a generic; the ATA guidelines state that levothyroxine sodium is the treatment of choice, without specifying brand-name or generic. However, both the ATA and AACE recommend that patients be retested and their dosage adjusted accordingly if patients switch levothyroxine products. (Neither The Endocrine Society nor the National Institute of Diabetes and Digestive and Kidney Diseases-the division of the National Institutes of Health that studies thyroid disease-has published guidelines for the treatment of thyroid disease or has a stated position concerning the brand-name vs. generic issue.) Because the FDA regulations only concern the amount of stated chemical content and because researchers cannot seem to agree on the most reliable and relevant methods for testing and comparing levothyroxine preparations, it appears likely that the controversy of brand-name or generic will continue for some time. Until more testing, evaluation, and information become available, The Thyroid Society believes that it would be prudent to continue to follow the same course of action that has yielded reliable, consistent results with a minimum of additional laboratory tests and office visits. Brand-name synthetic levothyroxine can assure physicians and patients predictable results and is, therefore, the levothyroxine preparation of choice.

Cost Factors

Patients may be concerned about the costs involved in lifetime thyroid hormone replacement. Compared to other drugs, levothyroxine is relatively inexpensive. As can be seen in the table National Comparisons, the average wholesale price for the three leading brand-name levothyroxine products in the U.S. varies as much as 40%.The previously mentioned controversial study implied that generics could save consumers a great deal of money, and, indeed, most people expect generics to be less expensive than brand-names. In fact, generic prices can either be much less expensive or more expensive than a given brand-name product, depending upon the manufacturer, distributor, and pharmacy (see table Levothyroxine Prices – Houston). Depending on where you buy your generic levothyroxine, it might cost more than a brand-name. If cost savings is the incentive to switch to generic levothyroxine, the additional laboratory testing and office visits recommended when patients change from one levothyroxine product to another could offset or exceed any perceived cost savings. Some patients have expressed concern that their managed healthcare program will restrict the use of brand-name levothyroxine. Each managed healthcare plan has developed a list of drugs (a formulary) that they will cover for certain diseases. Typically, the patient pays a flat rate, or co-pay, for each prescription they have filled, regardless of the actual cost of a drug. Some plans only allow a 30-day supply of any medication to be filled at one time. If the average co-pay is $5, the patient will spend a total of $15 for 90 tablets of levothyroxine-generic or brand-name-and will go to the pharmacy three times. The patient might have spent less money and avoided two additional trips to the pharmacy by paying in full for a prescription of 100 tablets of a lower priced brand-name levothyroxine. Patients should discuss with their physician any financial concerns they have about levothyroxine so that the physician can take this information into consideration when prescribing the best treatment for the patient. In addition, thyroid patients with managed healthcare plans can discuss their concerns about their treatment with the plan’s administrator.

Dosage

The exact amount of levothyroxine prescribed to correct thyroid disorders must be individualized for each patient. When determining the initial dose of levothyroxine, physicians take several factors into consideration:

  • The patient’s age
  • The patient’s weight
  • The patient’s heart status
  • The severity of hypothyroidism

The majority of patients can be started on full thyroid hormone replacement. Patients with a history of heart problems are sometimes started on an a relatively low dosage-25 mcg (0.025 mg) to 50 mcg (0.05 mg)-of levothyroxine. [EDITOR: In Australia, Sigma Pharmaceuticals, the maker of Oroxine, recommends that all patients start on a low dose. It is Thyroid Australia’s experience that petients starting on a full dose frequently experience overdose symptoms.] The amount of levothyroxine is gradually increased every four to six weeks until the patient becomes euthyroid.

Patients who have had their entire thyroid surgically removed because of thyroid cancer typically require considerably higher doses of levothyroxine than patients with Hashimoto’s thyroiditis who have some remaining thyroid function. In addition, women taking estrogens for birth control or menopause may require higher doses of levothyroxine. Patients should not expect to feel better immediately after beginning treatment with levothyroxine, even if the initial dosage is correct. It may take six weeks or more before they experience a full response to treatment. Patients are usually re- examined and have repeat thyroid function tests two to three months after they are started on levothyroxine. If dosage adjustments are necessary, patients are re-examined and tested in another two or three months. Once patients’ thyroid hormone levels are within the proper range, they are ordinarily seen no less than once a year. Physicians may change patients’ levothyroxine dosage for various reasons, including aging and changes in patients’ medical condition.

Patients who become pregnant or start taking estrogen should see their physician two months later to determine if their levothyroxine should be increased. Pregnant women should also be checked again when they are five to six months pregnant and three to four months after they deliver. Additionally, adjustments in the dosage of levothyroxine are sometimes necessary because of changes in the thyroid disease itself. For example, if a patient is being treated for hypothyroidism due to Hashimoto’s thyroiditis, over time, this inflammation could damage additional thyroid gland tissue, causing it to produce even less thyroid hormone.

When to Take Levothyroxine

Levothyroxine should be taken daily, unless otherwise directed by the physician. For patients who have trouble remembering to take their medication, inexpensive pill boxes can be helpful. If a pill is forgotten, the patient can either take it the next day or at the end of the week. (“Doubling up” on other medications is not advisable without first checking with a physician.) Since food- especially high-fiber food and soy bean products- can interfere with absorption of levothyroxine, it is best to take levothyroxine on an empty stomach, twenty to thirty minutes before breakfast. Several drugs can also cause absorption problems. For example, Feosol®, Fergon®, prenatal vitamins, and other preparations containing large amounts of iron can significantly interfere with levothy-roxine absorption. Another drug that can cause problems is sucralfate (Carafate®), which is used in the treatment of ulcers and esophagitis. Therefore, iron and sucralfate should be taken two to four hours after levothyroxine. Patients should also avoid taking levothyroxine and antacids containing aluminum hydroxide at the same time. Drugs used to treat high cholesterol, such as Questran® and Colestid® have an even more dramatic effect on levothyroxine absorption. These drugs should be taken at least four hours, and preferably twelve hours, after levothyroxine. The effects of drugs, supplements, and diet on levothyroxine absorption can be significant. Therefore, it is always advisable for patients to tell the physician treating their thyroid disease about all of the other medications or supplements they take. It is also important for thyroid patients to tell physicians treating them for other disorders that they are taking levothyroxine. The Thyroid Society strongly encourages patients to discuss their concerns about levothyroxine therapy with their physician. Each patient is unique, and the physician managing their disease is in the best position to advise them on their treatment plan. By focusing this edition of The Thyroid Connection on levothyroxine therapy, The Thyroid Society hopes that patients will better understand the importance of taking their thyroid hormone replacement and that they will find it easier to follow their physician’s instructions.

This article is reproduced in full and acknowledges the source below
(c) Copyright 2001, Thyroid Australia Limited ABN 71 094 832 023
333 Waverley Road, Mount Waverley, 3149, Australia
Thyroid Australia Home – www.thyroid.org.au

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What is Candidiasis?

Confused? Is it Candida, Fungi, Yeast or Candidiasis?

Fungi is a biological group of organisms that include yeasts, molds and fungi – meaning that yeast is fungi  but not all fungi are yeast. Candida is a group name for this type of yeast. It is normal to find Candida on human skin. Candidiasis (which I really think should be spelled candidaitis*) is (so far as I can tell) a term that means than candida has turned into a disease. Candidiasis is also technically known as candidosis, moniliasis, and oidiomycosis.

Candida albicans is part of the normal flora of the mucous membranes of the respiratory, gastrointestinal (gut or intestinal flora), and female genital tracts. In healthy people it causes neither irritation or disease until it changes form and starts to overgrow.

Candida Albicans

  • a yeast or single cell form
  • a cell wall deficient form
  • a colony of cells or mycelium
  • a chlamydospore or cyst like form

Candida yeast can exist in the above  four forms : The single cell form is normal. Candida Albicans is the most common disease causing species of yeast in our body.

Candidiasis

Candidiasis
Image via Wikipedia

There are over 150 species of Candida such as Candida tropicalis, Candida glabrata, Candida pseudotropicalis, Candida guillermondii,Candida krusei,  Candida lusitaniae, Candida parapsolis, Candida dubliniensis, – that can cause disease, especially if the immune system is weakened.

NB. Blue links on this page lead to wikipedia descriptions. On the Candida page you will see a list on the right of various different species of Candida, many of which have pages of their own.

Candida is not a disease as such. It can get out of hand however as Candidiasis or yeast overgrowth and that can disrupt the body’s normal functioning and lead to disease.

If yeast overgrowth escapes from the intestinal tract, it can invade virtually any organ of the body, including the blood, the lungs, bones, kidney, liver, eyes and brain. Candida bloodstream infections are called candidemia. In very severe infections, systemic candidiasis, people with low immune systems can die from a fatally high fever such as Candida meningitis.

There are treatments for systemic candidiasis. However, yeast overgrowth is difficult to test for as pockets of yeast can hide almost invisibly. Risk of contracting the systemic form of candidiasis is mostly confined to immune compromised infants or the aged, or to patients with AIS conditions such as diabetes, cancer, or HIV, who have weak immune systems.

Thrush and Tinea

Most people who have yeast infections have external or superficial yeast infections in the mouth, in the vagina and on the skin. Oral candidiasis or thrush in the mouth and common in elderly denture wearers, is called oropharyngeal candidiasis and vaginal thrush is called vulvovaginal candidiasis. Nappy Rash may be caused by Candida.

Athletes foot or Tinea is a common fungal infection, as is jock itch in males. People also get fungal infections under their nails called onychomycosis . Vaginal yeast infections in women are common after taking a course of antibiotics but regardless of gender, prolonged antibiotic use increases your risk of a yeast infection.

If people get a yeast overgrowth in their intestinal tract, their symptoms may not be specific enough to diagnose yeast overgrowth. The candida may penetrate the GI mucosa, damaging the gut walls and leading to IBS. More symptoms may include fatigue, achy joints, sleep disturbance, brain fog, bladder and bowel disruption, increase of allergies and sensitivity to foods and chemicals.

In healthy people, yeast infections can be cured with topical or systemic antifungal medications you can buy from the chemist  such as the topical creams clotrimazole, nystatin  and  ketoconazole. A one-time dose of fluconazole (150-mg tablet taken orally) is reported as being 90% effective in treating a vaginal yeast infection.

In most cases of Thrush the yeast overgrowth is treated with a cream and subsides in a few days to a fortnight. A single dose fluconazole tablet is a one day alternative treatment to the cream. Both generally work quickly and effectively. In severe infections amphotericin B, caspofungin, or voriconazole may be prescribed.

When Treatment Doesn’t Work

However sometimes these treatments don’t work. Perhaps this is because the yeast has adapted to the treatment and it no longer works. Or because the form of candida is not susceptible to it, such as Candida glabrata that may be less susceptible to the currently used azole antifungal treatment.

Then we start guessing as it gets more complicated from here.

The hospital doctors are aware of resistant candida, but by the time you’re in hospital with this, your other disease will be more important to them. General practice doctors are resistant to believing candida can be a major problem.

The treatment of candida now becomes a matter of opinion. The best is subjective – trial and error via anecdote such as discussions in forums. And website information from doctors – although some of these may be somewhat biased towards specific remedies.

Notes

 *  -itis

  1. Suffix denoting diseases characterized by inflammation, often caused by an infection.
  2. (humorous) Used to form the names of various fictitious afflictions or diseases.

What is Candida

What is Candida? More Commonly known as Thrush or A Yeast Infection

What may arguably be the most commonly encountered yeast infection or form of candida is often referred to as thrush.  and they are caused in human beings by a genus of fungi called Candida. Yeast infections affect either gender in certain specific areas of the human body. It is more common for women especially when it affects the female genitalia.

Thrush
Image by AJC1 via Flickr

Yeast infections affect the skin or mucous- membrane areas,  It appears in laboratory-cultured agar plates as large, round colonies colored white, cream or whitish-gray. The image here shows a severe case  of thrush in a mouth with the unmistakeable white plates.

The most commonly known species of yeast overgrowth is called Candida Albicans, although Candida albicans is not the only species that causes yeast infections in human beings. It is thought there may be several hundred varieties.

Candida albicans in a normal quantity generally lives harmoniously with other flora in the human body, its growth kept in check by other bacteria. But it thrives in warm, wet areas of the body. This is why yeast infections are found in mucous membrane areas such as the mouth and the vagina. It also likes human skin, particularly  sections that are prone to sweat such as the skin folds around the genitalia, under the breasts and armpits, and between the toes. In extremely severe cases it can also infect the blood, the bowel and intestines and other interior areas.

So what actually causes yeast infection? First, the human body’s temperature must be at a specific level and the pH levels must be balanced, two of the conditions necessary for Candida albicans and its partner bacteria to grow without disturbing other flora. But when the body temperature and pH levels change, these controlling bacteria die. This leaves the Candida albicans cells free to replicate and turn into fungi with no control over themselves.

Thrush causes burning or prickly sensations, with soreness, itching, tingling and sometimes numbness.  The yeast overgrowth also causes specific symptoms in afflicted areas. To name a few, yeast infections create white or cream-colored patches inside the mouth, reaching as far as the soft palate. They can cause digestion problems and make bowel movements difficult. Afflicted penises have patchy sores near the head or on the foreskin. Candidiasis may  also be responsible for discharges from the ear, the bowels (in the stool) and the genitalia.

Other symptoms may include fatigue, drowsiness, muscle aches, pain or swelling in the joints, dizziness, fluid retention, tissue swelling, loss of balance, lack of coordination, lack of concentration, poor memory, mood swings, depression, anxiety, and irritability. The yeasts feed on sugar so you may experience cravings for sugars, carbohydrates and alcohol.

But as these are also common symptoms for other sicknesses, this must be taken into consideration alongside more reliable indicators. A medical diagnosis should be made before treatment is started. If the infection is around the genitalia you may need to go to a sexual disease centre even though candida is not generally considered as a std. The clinic will however have the necessary staff to protect your privacy when the practitioner examines you.

Yeast infections can have serious, sometimes even fatal, consequences if they proliferate inside the body. This is particularly true for sufferers with weakened immune systems, diabetes, the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). Long term treatment is often required and sometimes no cure is possible, only management of the infection.

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