Hyperthyroidism Awareness

It is important to remember that hyperthyroidism can occur at any age. While most may present with a rather typical constellation of symptoms, many may present with exacerbation of pre-existing conditions which may make the diagnosis initially elusive. Worsening anxiety, insomnia, fatigue, panic attacks, palpitations, hypertension or diarrhea may not initially signal that the thyroid is involved. Clinicians must have a low threshold to check thyroid function early to rule out a component of hyperthyroidism.

Once a suppressed thyrotropin (TSH) has been detected, further investigation with serum triiodothyronine (T3) and free thyroxine (free T4) can help delineate overt from subclinical disease. A thorough history of past thyroid disease, as well as current medications and supplements, can help detect any pre-existing diagnoses or exogenous sources of thyroid hormone or over supplementation with iodine. More commonly, hyperthyroidism is due to either Graves diseasetoxic multinodular goiter or toxic adenoma. Distinction between these can usually be made with the assistance of a thyroid uptake scan, TSH receptor antibody measurement, and thyroid ultrasound. An additional physical exam finding of exophthalmos can further support the diagnosis of Graves’ disease. Understanding the etiology can help guide patient expectations. A small percentage of patients with Graves’ Disease may undergo spontaneous remission after 1 to 2 years, which may prompt patients to wait before considering a definitive treatment option.

With confirmation of the diagnosis of hyperthyroidism, focus is on hormonal control with an antithyroid medication (ATM, most commonly Methimazole in the United States). This may be augmented with beta-blockade, steroids, cholestyramine or SSKI for those who are difficult to control.

Many patients may need further consideration for definitive management with either radioactive iodine ablation (RAI) or thyroidectomy. Your local resources may also influence these options, but it is critical to understand that all three treatments (ATM, RAI and thyroidectomy) are possible options. Certain patient factors and priorities may alter the preferred definitive treatment. Smaller gland size, easy to control hormones, and lack of eye symptoms are factors that may favor continued ATM management. A large goiter with compressive symptoms, difficult to control hormones requiring high dose medications/ multiple modalities, pregnancy, severe eye disease, multiple nodules within the thyroid with or without thyroid cancer, or desire for rapid and reliable hormone control may favor thyroidectomy. RAI is a good option for patients with a smaller gland size, and a desire to pursue definitive management but avoid surgery.

There are also relative contraindications for treatment options. ATMs may have serious side effects, like agranulocytosis or liver failure, which prevent further use, or may cause skin eruptions making long term use intolerable. Additionally, high dose requirements or fluctuating doses may make long term use of ATMs not reliable. Women who are pregnant, wanting to become pregnant in the next 6 months to 1 year, breast feeding or have small children in the home will want to avoid RAI. Patients with severe eye involvement, have a large goiter with compressive symptoms, or are smokers should also avoid RAI. Thyroidectomy will be a poor option for patients with multiple previous neck operations on or around the thyroid due to internal scarring, or who are high risk for general anesthesia. Additionally, if they have a history of previous gastric bypass surgery, they are higher risk for major complications from hypocalcemia/hypoparathyroidism after thyroidectomy.

To help the patient navigate these decisions, it is important to allow them the opportunity to discuss each treatment option with respective physician experts – medical management with endocrinology, RAI with endocrinology and potentially nuclear medicine as well, and thyroidectomy with the thyroid surgeon.

In summary, patients with hyperthyroidism require medical control, as well as a clear understanding of the etiology of their hyperthyroidism. Patients with Graves disease, toxic multinodular goiter and toxic adenoma have more than one treatment option, and it is important for patients to be educated and engaged in treatment decisions.

For Further Reference:
American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and other causes of Thyrotoxicosis| by the American Thyroid Association

Hugging might even lower heart rates and blood pressure

The university of North Carolina conducted a studies with 59 women and found some interesting results after a short series of questions and general chatting about their partner some women ended each session with a 20 second hug

The women who received a hug from their partner had lower blood pressure and heart rates during stressful section of testing the researchers think that oxytocin that we mention earlier might be the causes for their better heart health

Hugging can be good for your heart health. In one studyTrusted Source, scientists split a group of about 200 adults into two groups:

  • One group had romantic partners hold hands for 10 minutes followed by a 20-second hug with each other.
  • The other group had romantic partners who sat in silence for 10 minutes and 20 seconds.

People in the first group showed greater reductions in blood pressure levels and heart rate than the second group.

According to these findings, an affectionate relationship may be good for you heart health.

Oxytocin is a chemical in our bodies that scientists sometimes call the “cuddle hormone.” This is because its levels rise when we hug, touch, or sit close to someone else. Oxytocin is associated with happiness and less stress.

Scientists have found that this hormone has a strong effect in women. Oxytocin causes a reduction in blood pressure and of the stress hormone norepinephrine.

One study found that the positive benefits of oxytocin were strongest in women who had better relationships and more frequent hugs with their romantic partner. Women also saw positive effects of oxytocin when they held their infants closely.

A GUIDE TO BREAST CANCER

WHAT IS BREAST CANCER?

Cancer appears when changes called mutations take place in genes that control cell growth. The mutations let the cells divide and multiply in an unrestrained way.

Breast cancer is cancer that grows in breast cells. Normally, the cancer forms in either the lobules or the ducts of the breast.

Lobules are the glands that create milk, and ducts trails that milk from the glands to the nipple. Cancer can also happen in the fatty tissue or the fibrous connective tissue within your breast.

The uncontrolled cancer cells often attack other healthy breast tissue and can move to the lymph nodes under the arms. The lymph nodes are a main pathway that assist the cancer cells travel to other parts of the body.

SIGNS AND SYMPTOMS:

In its initial stages, breast cancer may not show any symptoms. In many cases, a lump may be too small to be felt, but an irregularity can still be seen on a mammogram.

If a tumour can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancerous.

Each type of breast cancer can cause a diversity of symptoms. Many of these symptoms are alike, but some can be unusual. Symptoms for the most common breast cancers include:

  • a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
  • breast pain
  • red, pitted skin over your entire breast
  • swelling in all or part of your breast
  • a nipple discharge other than breast milk
  • bloody discharge from your nipple
  • peeling, scaling, or flaking of skin on your nipple or breast
  • a sudden, unexplained change in the shape or size of your breast
  • inverted nipple
  • changes to the appearance of the skin on your breasts
  • a lump or swelling under your arm

If you have any of these symptoms, it doesn’t necessarily mean you have breast cancer. For instance, aching in your breast or a breast lump can be caused by a benign cyst also.

Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.

RISK FACTORS:

Risk factors for breast cancer include:

  • Age. Your risk for developing breast cancer increases as you age.
  • Drinking alcohol. It raises your risk to develop the disease.
  • Having dense breast tissue. 
  • Genes. Women who have the BRCA1 and BRCA2 gene mutations are more likely to develop breast cancer than women who don’t. Other gene mutations may also affect your risk.
  • Early menstruation. If you had your first period before age 12 years, you have an increased risk for breast cancer.
  • Giving birth at an older age. Women have their first child after age 35 years have an increased risk for breast cancer.

BREAST CANCER PREVENTION:

  • Lifestyle factors: For instance, women who have obesity have a higher risk for developing breast cancer. Maintaining a nutrient-dense diet and getting regular exercise as often as possible could help you lose weight and lower your risk. Alcohol misuse also increases your risk
  • Breast Cancer Screening
  • Preemptive Treatment
  • Self-Exams
  • Breast Exam by Doctors

10 symptoms that you are going through stress

1. Mood Swings

2. Frequent or easily crying

3. Lack of focus and concentration

4. Emotionally sensitive

5. Anxious about worst-case scenarios

6. Quick lose of temper or irritability

7. Having issues in decision making

8. Irregular sleep or digestive issues

9. Memory/ recall problems

10. No motivation to do anything

These are the symptoms and you have to take care of them by giving attention to them. The first thing is by reading self-help books. Self-books are the best start to cure your stress. It will be hard to start at first but if you go through them for 21 days then it will become a habit for you and as well as your daily routine. Especially in this lockdown, everyone is facing stress because of confided in our homes. We can also install some apps from playstore to destress our stress.

If you can draw well please draw at least one picture a day to defeat your stress demon. after seeing the outcome of our result our heart will feel light. In these covid times, try to step out of your room and go to your terrace to get some good air. Because staying in our rooms increases the chances of negative vibration.

The next thing many people noticed is staying in a toxic relationship. If you are staying in a toxic relationship try to leave that immediately. It is the biggest stress of your life. This toxic relationship might also turn into verbal and physical abuse in later days. The faster you leave the better your future will be.

Try to stay motivated. I know this is the toughest thing to do. But nothing is impossible if we do some regular practices. Try to do at least one good thing in your day. It can be teaching some underprivileged children by joining some NGO. There are lots of NGOs that want people to volunteer to help those young minds. It will be a good deed for your life.

One of the best things to ease our stress is by doing some breathing exercises. Doing breathing exercises will help you to maintain a healthy heart. Sometimes you might feel it is not good to share your problems with others because they will judge you after hearing your story then try to write them in an online journal. This is the best practice followed by many people and it has helped them a lot. Even I wrote my feelings in an online journal. There are lots of apps available in playstore. Install the one which contains password protection. 

Watch some funny series. If you have a Prime subscription then use it to watch series and you can also read books for free if you have a Prime subscription. Kindle provides a Prime Reading feature for Prime subscribers and you can read famous books for free without spending a single penny. When things come for free we should make the best use of them.

We should not underestimate ourselves. We can write things that we are grateful for. Or the achievements we made till now in our life. Try to write a bucket list and set goals for yourself to achieve them. This will help you to prioritize things in your life.