thyroid disease article

["Franta, Jaroslav" <frantaj@aecl.ca>]

posted at http://www.saturdaynight.ca/articles/topstory2.asp
is this interesting article from the Nov. 18 issue of Saturday Night
magazine - a weekend supplement in the National Post newspaper.
Note especially the part about US president George Bush, who had his Grave's
disease (hyperthyroidism) treated with radioactive Iodine-131....

Jaro
frantaj@aecl.ca

<BEGIN QUOTE>

> ONE PILL A DAY, FOR THE REST OF YOUR LIFE
> By Brad Evenson [ medical writer for the National Post ]
> 
<SNIP> 
> Ours is one of the highest rates of thyroid treatment in the world; three
> times more Canadians will be diagnosed with thyroid disease than cancer
> this year. Still, some researchers think only 60 percent of Canadians with
> thyroid disease are actually getting treatment. And as far as thyroid
> cancer is concerned, the news is even more disturbing: its incidence in
> Canadian women is rising at more than 6 percent a year -- twice the speed
> of almost every other cancer. 
<SNIP>
> Do we have a creeping epidemic of thyroid disease in our population? Or
> are we just now discovering the true extent of a problem that has always
> been with us? 
<SNIP>
> Until the early 1900s, scores of North Americans suffered goitres --
> swollen thyroid glands -- and a host of other ailments due to a lack of
> iodine. Patients looked like bullfrogs with engorged throats. The U.S.
> midwest and the Great Lakes regions were once known as a "goitre belt"
> because glaciers had stripped away much of the soil that contained iodine.
> 
<SNIP>
> As many as seven times more women than men suffer from thyroid disease,
> which often strikes after menopause or childbirth. 
<SNIP>
> Thyroid disease is a close cousin to diabetes; both can result when the
> immune system inhibits or harms a gland that makes a vital hormone. The
> prevalence rates are similar. About 1.5-million Canadians have diabetes.
> Similar numbers have thyroid disease.
<SNIP>
> says Lottie Garfield, a spokesperson for the 3,500-member Thyroid
> Foundation of Canada. "It's not life-threatening, generally, unless it's
> neglected . . . and it's treatable. But until it's treated, it can be very
> difficult." 
<SNIP>
> The actual gland tissue may be expendable -- it is often surgically
> removed or disabled with radioactive iodine -- but the hormones it
> secretes are anything but. 
> 
> Thyroid diseases can harm the cardiovascular system, reproductive tract,
> and major organs. If untreated, they can lead to anemia, a low body
> temperature, and heart failure. They can proceed to confusion, or stupor,
> and seizures, as blood flow to the brain decreases. The most common
> symptoms are fatigue, mild weight gain or loss, weakness, depression, and
> a persistent hoarseness. 
<SNIP>
> The symptoms might also be difficult to interpret. On a Saturday afternoon
> in May, 1991, while jogging around the grounds of Camp David, U.S.
> president George Bush experienced shortness of breath, tightness in his
> chest, and a general sensation of fatigue. It looked like a heart problem.
> This seemed to be confirmed when a White House doctor discovered Bush's
> heart was beating rapidly and irregularly, a condition called atrial
> fibrillation, and instantly arranged for the president's admission to
> Bethesda Naval Hospital. When Bush described his recent medical history,
> he told doctors he had been feeling increasingly tired in the previous
> fourteen days. He had lost nine pounds in the previous two months. And his
> handwriting, never pretty to begin with, had deteriorated. A careful
> physical exam revealed Bush had a fine tremor in his hands and a slight
> goitre, a swollen thyroid. The diagnosis: he had Graves' disease. The
> excess thyroxine was overstimu lating his heart and disrupting its normal
> rhythm. 
> 
> If Bush's hyperthyroidism had gone untreated, as such cases sometimes do,
> it could have resulted in a life-threatening condition known as "thyroid
> storm," a sudden extreme overactivity of the gland causing fever,
> weakness, mood swings, confusion, and, in extreme cases, heart failure. To
> prevent this and to ensure he could resume his presidential schedule
> quickly, Bush took radioactive iodine. He also took three drops of
> potassium iodide every day. Gradually, the radioactive iodine destroyed a
> large part of his thyroid, reducing its output, and the president -- like
> millions of North Americans -- began taking levothyroxine. 
> 
> When the media learned that Bush's wife, Barbara, had been diagnosed with
> Graves' disease just eighteen months earlier, a very rare husband-wife
> incidence, some conspiracy theorists hinted that the White House water
> might be a factor, a possibility laughed off by the Bush administration. 
<SNIP>
> Since the thyroid works by drawing iodine from the blood, it's crucial
> that everyone have an adequate supply. But the food supply of a quarter of
> the world's population is iodine deficient. As many as 150 countries in
> the developing world have endemic goitre problems, and the World Health
> Organization has made iodization a priority. In Canada, however, we may
> have gone too far. 
<SNIP>
> In the 1930s, the average Canadian consumed about thirty to forty
> micrograms of iodine a day. Today, it's close to 600 micrograms. The
> problem is that too much iodine consumption can trigger thyroid disease --
> "one of the ironies of intervention," notes Dr. Walfish. 
<SNIP>
> Canada's population is ageing, and thyroid disease tends to strike later
> in life. 
<SNIP>
> Between 1988 and 1995, new cases of thyroid cancer shot up by 3.5 percent
> in men and 6.3 percent in women, most of it papillary thyroid cancer. The
> incidence of most other types of cancer fell in that period. 
> 
> "The high iodine intake seems to favour the spectrum of autoimmune thyroid
> disease, as well as papillary thyroid cancer," says Dr. Walfish. "We often
> see the two diseases co-existing, and there's been speculation as to
> whether a high iodine intake predisposes [a person] to autoimmune thyroid
> disease, and maybe the type of thyroid cancer called papillary. I don't
> think there's a direct cause and effect, but I think there's an
> association. We definitely see a lot more [cases] these days." 
> 
> Dr. Mahshid Lotfi, an Ottawa nutrition researcher, says the iodization of
> salt is one of the great success stories of Canadian public health.
> However, she thinks the fifty-one-year-old iodine regulations should now
> be revisited. Health Canada, however, has not shown any interest in doing
> so. 
> 
> Does it matter? With levothyroxine to keep it at bay, why not abandon the
> hunt for what causes thyroid disease? After all, thyroid disease is rarely
> fatal. Only a few scientists do research on it. Why bother? Treatment is
> easy. It's cheap. Just take a pill. Every day for the rest of your life. 
<END QUOTE>

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