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Thyroid disfunction is recognized globally as one of the conditions of the endocrine system but there are variations of how common it is in individual countries. Consuming excessive iodine can lead to the dysfunction of the thyroid gland and iodized salt is a high contributor (Flores-Rebollar et al., 2021). In the United States, women have a higher diagnosis of hyperthyroidism than men by 3% to 0.5%. This is a condition caused by increased thyroid hormone. Signs of hyperthyroidism include protruding eyeballs which causes eye irritation and pain, blurred vision, photo sensitivity and goiter (McCance & Huether, 2018). The opposite is hypothyroidism, where the thyroid gland does not produce enough thyroid hormone. According to McCance & Huether, women and the older generation are the most affected in the united States and it is the most common of the thyroid dysfunction. This can be the effect of trauma, radiation, congenital defects in children and dysfunction of the pituitary gland. People with hypothyroidism may exhibit cold intolerance, feeling fatigued, lethargy and goiter due to increased production of thyroid-stimulating hormone (2018).
According to Arcangelo et al., (2017), hyperthyroidism is caused by excessive production of the thyroid hormone and hypothyroidism is caused by a decreased production of the thyroid hormone. Except for goiter that occurs in both conditions, hypothyroidism symptoms are the opposite of hyperthyroidism symptoms. Unintentional weight loss, cardiac arrhythmia, palpitations and increased appetite with hyperthyroidism and with hypothyroidism, the body’s metabolism is slowed down causing excessive weight gain due to water retention. The main blood test performed for both conditions are thyroid-stimulating hormone (TSH), T4, and T3. A combination of the levels symptoms determines the diagnosis.
Antithyroid medications for hyperthyroidism are given to slow the progression of the condition and as mentioned by Arcangelo et al., methimazole (tapazole) and propylthiouracil (PTU) are the prescribed drug of choice for healthcare providers. The purpose of these drugs is to block iodine from the production of thyroid hormones. Patient must be monitored for hypothyroidism while on the medications. Beta-blockers are prescribed to manage the cardiac arrhythmia and palpitations. Levothyroxine (Synthroid) and liothyronine (Cytomel) are the thyroid hormone replacement medications prescribed for hypothyroidism. The benefit of these treatments is to replace the hormone the body is unable to produce. People on thyroid hormone replacement drugs must be monitored for drug interactions with phenytoin, carbamazepine. The absorption of the thyroid hormone will be altered. Patients on anticoagulants should be monitored for increased bleeding with hypothyroidism therapy and passible clot formation due to coagulation (Arcangelo et al., 2017). Education should include taking the medications on an empty stomach, thirty minutes before eating, not to stop taking the medication without consulting a healthcare provider and consistency with the time of day the medication is taken.
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for Advanced Practice: A Practical Approach (4th ed.). In L. R. Petrone (Eds), Thyroid disorders (pp. 2304-2353). Wolters Kluwer. IBSN: 9781496319968
Flores-Rebollar, A., Pérez-Díaz, I., Vega-Vega, O., Rivera-Moscoso, R., Fagundo-Sierra, R., Carbajal-Morelos, S. L., Osorio-Landa, H. K., López-Carrasco, M. G., Lira-Reyes, A. R., & Correa-Rotter, R. (2021). Prevalence of thyroid dysfunction in healthy adults according to the estimated iodine intake in 24-hour urine samples: The SALMEX cohort. European Journal of Nutrition, 60(1), 399–409. https://doi-org.aspenuniversity.idm.oclc.org/10.1007/s00394-020-02254-9
McCance, K. A. & Huether, S.E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby. ISBN: 978032341320.