1/06/2017

15 Things Your Thyroid Can Affect





Maybe you've heard people say, "I'm tired because I have a thyroid problem." Or, "I see an endocrinologist because I have thyroid issues." But how much do you really know about your thyroid? 
The thyroid is a small gland that is butterfly shaped and located at the base of the neck, just below the Adam's apple. It's part of the endocrine system, which helps coordinate many of your body's activities. The gland makes hormones that regulate your metabolism. But when it's not working right, your body can be affected in various ways.
You don't produce enough hormone.
Hypothyroidism is also known as Hashimoto's disease or Hashimoto's thyroiditis. It is most common in middle-aged women, but Hashimoto's disease can happen at any age. Here, your immune system mistakenly attacks and slowly destroys the thyroid gland and its ability to make hormones. Treatment may include taking daily medication (which you'll likely need for the rest of your life since it restores adequate hormone levels) and monitoring the dosage to ensure you're taking the right amount. Your doctor may pass on medication and take a wait-and-see-approach. 
You produce too much hormone.
Hyperthyroidism is also known as Graves' disease. This autoimmune disorder happens when the body's immune system mistakenly attacks the thyroid gland. It's hereditary and is most common in women ages 20 to 30. Some treatments include radioactive iodine therapy (taking radioiodine orally), prescription antithyroid medications (which interfere with the thyroid's use of iodine to produce hormones), beta blockers (which block the effect of hormones on the body) or surgery to remove all or part of your thyroid. 
You have a goiter.A goiter is a noncancerous enlargement of the thyroid gland. It's often caused by a lack of iodine in your diet. It's most common in parts of the world that lack iodine-rich foods and are more common in women and after age 40. Treatments depends on your symptoms, the size of the goiter and the underlying cause. Small goiters that aren't noticeable or problematic typically don't need treatment. 
You have a thyroid nodule.
Thyroid nodules are growths that form in or on the thyroid gland. They can be caused by Hashimoto's disease and iodine deficiency, though the causes aren't always known. Most are benign, but a small percentage of cases can be cancerous. They're more common in women, and your risk increases as you get older. Symptoms may resemble hyperthyroidism if you have abnormally high levels of the hormone in your bloodstream. Symptoms will be like hypothyroidism if the nodules are linked to Hashimoto's disease. Treatment depends on the type of thyroid nodule. 
Your sleep changes.
You've always been a good sleeper but suddenly can't sleep through the night? You may have an overactive thyroid, which is pumping out some hormones excessively. And that can overstimulate the central nervous system and lead to insomnia. You may also need more sleep than usual, feel tired despite a good night's sleep or have the urge to nap. That means you may have an underactive thyroid. 
Your hair is thinning.
Thinning hair, especially on the eyebrows, is a common sign of thyroid disease. An overactive or underactive thyroid affects your hair's growth cycle. Usually, most of your hair grows while some of it rests. But when your thyroid is out of order, too much hair rests at once. And that makes your hair look thinner. 
You're sweating excessively when you shouldn't be.
You're not even at the gym but you're sweating excessively. That's a common sign of a hyperactive thyroid. Since your hormone levels are higher than normal, you feel warm. 
Your skin is dry in the summer.
You may have hypothyroidism. Why? A slower metabolism can decrease sweating. And that means your skin has less moisture, making it dry. 
You suddenly feel anxious.
If you start feeling unsettled or anxious and you've never had that issue, you may have a hyperactive thyroid. Because your thyroid hormone levels are high, you feel anxious, nervous, irritable, shaky or jittery. 
You have unexplained weight gain.
When you have a lack of hormones due to an underactive thyroid, your metabolism decreases and you burn fewer calories. So, your pants may feel snug, though your exercise or eating habits have remained the same. 
You aren't gaining weight.On the flip side, you may be losing weight without changing what you eat or how you exercise. Here, you may have an increased metabolism, due to an overactive thyroid. You're hungrier and eating more, but you aren't gaining weight.
You're forgetful.
Some people say they're in a brain fog when they have an underactive thyroid. Others say they have subtle memory loss, overall mental fatigue or difficulty concentrating. That can all be blamed on an underactive thyroid.
Your bowel movements change.
You may have an underactive thyroid if you're frequently constipated. The thyroid helps regulate your digestive track. But if you don't produce enough thyroid hormones, things can get backed up. And if you have an overactive thyroid, you'll have regular bowel movements but need to go more frequently since everything is sped up.
You have too much energy.
Your body processes speed up when you have too many hormones. You may feel like you've had too much coffee or feel like you're having heart palpitations, even when you're relaxed. 
Your periods have changed.
You may not be producing enough hormones if your periods have become longer, heavier or closer together. You may be producing too many hormones if they occur further apart or have gotten lighter.
Post Polio Litaff, Association A.C _APPLAC Mexico

The Polio Crusade

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Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

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A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

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