A Silent
Cause of Weight Loss
by
Louito
C. Edje, MD
Nancy W. is a 24 year-old woman who I noticed was
losing weight without much effort. She had also noticed that her heart
seemed to beat fast even if she had not been particularly active. Her
periods were much lighter than normal over the past three months.
She made an appointment with me because she wanted to
make sure she was okay before she tried to become pregnant. After further
inquiry she admitted to having some difficulty tolerating heat and had a
fine tremor of her hands. A friend that she had not seen in a while had
mentioned that her eyes looked different from their appearance the last
time they had seen each other.
I examined Nancy and found her thyroid to be soft
and mildly enlarged. The thyroid is a bow-tie shaped organ that lives in
the same location that a bow-tie would be found in the lower half of the
neck. It has many responsibilities including regulation of menstruation,
maintenance of normal body temperature and metabolism. Nancy’s eyes
appeared prominent but her vision was good. Her heart rate was slightly
increased but very regular. She had lost fifteen pounds in the year since
I had previously seen her.
We discussed obtaining some blood work to find out
how her thyroid was functioning and decided to do a thyroid uptake scan to
give us a picture of her thyroid in action. The thyroid uses iodine to
make its hormone. An overactive thyroid is likely to utilize more
iodine. The scan allows us to determine how aggressively the thyroid is
using iodine that has been specially labeled. The scan typically takes
several hours to complete.
Nancy‘s thyroid hormone levels indicated that she
had an overactive thyroid. The scan confirmed this and reassured us that
there was no overactive cancerous thyroid tissue. This particular form of
overactive thyroid is called Grave’s disease. The treatment of overactive
thyroid disease primarily consists of decreasing the thyroid activity.
Nancy decided to try medication to manage her
thyroid condition, her other options include taking a one-time dose of
radioactive iodine to decrease the function of the thyroid and one other
option is surgery to decrease the thyroid size.
My patient is feeling like herself again, her weight
has stabilized. She plans to attempt getting pregnant and during her
pregnancy we will be monitoring her thyroid hormone levels closely.
Louito C. Edje, MD
Academy of Medicine of Toledo and Lucas County
