From the Publisher

From patient advocate and author of Living Well with Hypothyroidism Mary J. Shomon, here is a holistic roadmap for diagnosis, treatment and recovery for the millions of people suffering from Graves' disease and hyperthyroidism.

There are an estimated 3 million-plus Americans suffering from Graves' disease and hyperthyroidism, and patient advocate Mary J. Shomon will guide them through the diagnosis and the wide-ranging treatments available. Graves' disease and hyperthyroidism are the result of the thyroid gland being overactive. This gland controls the body's metabolism, so people afflicted with the disorder can suffer from symptoms such as significant weight loss, fatigue, muscular weakness, and rapid heartbeat, among others. In addition to conventional treatments, this resource uniquely highlights holistic treatments, and through case studies and testimonials from patients and doctors, presents an honest look at the lifestyles and choices of people living with these conditions.

Shomon presents the reader with a comprehensive resource that spans from diagnosis to treatment to life after treatment. She goes beyond the conventional advice of other books, utilizing patient anecdotes and, as a fellow thyroid disease patient, her own experience. Her extensive network of experts—from conventional physicians to alternative practitioners—allows for a wide range of treatment options. In addition, a comprehensive Appendix serves as a fantastic resource for patients seeking treatment and additional advice.

The first edition of Living Well With Hypothyroidism (2/2000) started with a first printing of 7,500 copies and has now sold over 100,000 in theUS. Shomon's The Thyroid Diet hit the New York Times extended bestseller list.

Mary Shomon has been praised by doctors around the country for her medical knowledge and sensitivity to patients' needs.

Barbara Bush brought attention to the plight of Graves' disease patients, announcing that she was suffering from it when she was First Lady.

Library Journal

In her latest contribution to the "Living Well with" series (see also Living Well with Autoimmune Disease), patient advocate Shomon focuses on Graves' disease and hyperthyroidism. Readers will encounter the standard chapter breakdowns of most consumer health texts: medical explanation, traditional/complementary treatments, and planning for the future. Shomon excels at comprehensiveness, covering all the decisions that a patient has to make when dealing with thyroid conditions; an extensive resources appendix helps direct readers to other relevant resources and organizations. It does, however, take some effort to pin down the source of Shomon's medical information. While she quotes from personal interviews with medical experts, she sometimes neglects to give full citations. Libraries that already own similar titles-e.g., Elaine A. Moore's Graves' Disease: A Practical Guide and Kenneth Ain and M. Sara Rosenthal's The Complete Thyroid Book-can safely pass on Shomon's book. Only larger hospital and public libraries without such resources should consider. (Index not seen.)-Elizabeth J. Eastwood, Mesa P.L., Los Alamos, NM Copyright 2005 Reed Business Information.

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Living Well with Graves' Disease and Hyperthyroidism

HarperCollins Publishers, Inc.

Chapter One

Your Thyroid, Graves' Disease,
and Hyperthyroidism

What Is the Thyroid?

The word thyroid comes from the Greek word thyreoeides, meaning "shield-shaped." The two lobes of the thyroid are known as the "wings of the butterfly" and the area connecting the two lobes is known as the "isthmus." Generally speaking, a gland is a discrete and separate soft body made up of a large number of vessels that produce, store, and release -- or secrete -- some substance. The thyroid is a small gland normally weighing only about an ounce. It is located in the lower part of the neck in front of the windpipe. You'll know where the thyroid is if you think of it as sitting behind your Adam's apple.

Glands that secrete their products inside the body, and more specifically those that secrete hormonal and metabolic substances, are known as endocrine glands. This makes your thyroid an endocrine gland, along with the parathyroids, the adrenal gland, the pancreas, and the pituitary gland. Diabetes, like thyroid disease, is considered an endocrine disorder. A doctor who specializes in treating patients with endocrine problems is called an endocrinologist. Hormones are internal secretions carried in the blood to various organs. Your thyroid's main purpose is to produce, store, and release two key thyroid hormones: triiodothyronine (T3) and thyroxine (T4). The numbers refer to the amount of iodine molecules attached to each hormone. Thyroid cells absorb iodine. The thyroid obtains iodine through food, iodized salt, and supplements, then combines it with the amino acid tyrosine, converting the iodine/tyrosine combination into T4 and T3.

A healthy, functioning gland produces about 80 percent T4 and 20 percent T3. T3 is, however, the biologically active hormone that is used by the cells and is several times stronger than T4. The body converts the inactive T4 it produces to active T3 by removing one iodine molecule. This process is sometimes referred to as T4 to T3 conversion, or by the more scientific term monodeiodination. This conversion can take place in organs other than the thyroid, including the hypothalamus, a part of your brain.

T4 and T3 exist in two forms: free/unbound and bound. Free or unbound T4 or T3 is biologically active, and the bound part is bound to the thyroxine-binding globulin (TBG) protein. When measured in the blood, the free or unbound T4 and T3 levels tend to be most representative of the actual hormone available for use by the body.

The role of thyroid hormones is to control your metabolism -- the process by which oxygen and calories are converted to energy for use by your cells and organs. There's not a single cell in your body that doesn't depend on thyroid hormones for regulation and for energy in some form. Thyroid hormones have a number of functions as they travel through the bloodstream:

• Thyroid hormones help cells convert oxygen and calories into energy.
• Thyroid hormones help you properly process carbohydrates.
• Thyroid hormones aid in the proper functioning of your muscles.
• Thyroid hormones help your heart pump properly and effectively.
• Thyroid hormones help you breathe normally.
• Thyroid hormones help your intestinal system properly digest and eliminate food.
• Thyroid hormones help strengthen your hair, nails, and skin.
• Thyroid hormones help your brain function properly.
• Thyroid hormones help with proper sexual development and functioning.
• Thyroid hormones help with normal bone growth.

Now that you have some idea of what the thyroid is and its location and function, let's look in more detail at how it fits into the overall functioning of the body.

The Thyroid Gland: Setting the Pace

When your thyroid works normally, it produces and secretes the amount of T4 and T3 necessary to keep various bodily functions moving at their proper pace. However, the thyroid does not do this alone. It works as part of a bigger system that includes the pituitary gland -- an endocrine gland located at the base of your brain -- and the hypothalamus.

Here's how the system works. The hypothalamus constantly monitors the pace of many of the body's functions. It also observes and reacts to a number of other factors, including environmental conditions such as heat, cold, and stress. If the hypothalamus senses that certain adjustments are needed to react to any of these factors, it produces thyrotropin-releasing hormone (TRH).

TRH is sent from the hypothalamus to the pituitary gland. The pituitary gland then produces a substance called thyrotropin, better known as thyroid-stimulating hormone (TSH). The pituitary gland also monitors the body and can release TSH based on the thyroid hormones circulating in your blood. TSH is sent to the thyroid gland, where it causes your gland to produce, store, and release more T3 and T4.

Released thyroid hormones are carried through the bloodstream by a plasma protein known as thyroxine-binding globulin (TBG). Now in the bloodstream, the thyroid hormone travels throughout the body, carrying orders to various organs. Upon arriving at a particular tissue in the body, thyroid hormones interact with receptors located inside the nucleus of your cells. Interaction of the hormone and the receptor will trigger a certain function, giving directions to that tissue regarding the rate at which it should operate.

When the hypothalamus senses that the need for increased thyroid hormone production has ended, it reduces production of TRH, which causes the pituitary to decrease production of TSH, which then slows production of thyroid hormone. This system keeps many of the body's organs working at the proper pace.

Think of the entire feedback loop as resembling the thermostat in your house. It's set to maintain a particular temperature, and when it detects that your house has become too hot, it signals the heating system to stop blowing heat. Similarly, when the house becomes too cold, the heat will kick on (or the air conditioning will turn off). Like a thermostat set to a particular temperature, your body is wired to maintain a certain level of circulating thyroid hormone function. When thyroid disease or conditions interfere with the system and the feedback process doesn't work, thyroid problems can develop.

Continues...

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Excerpted from Living Well with Graves' Disease and Hyperthyroidism by Mary Shomon Copyright © 2005 by Mary Shomon.
Excerpted by permission.
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