Thyroid disorders: Too much or too little, but highly treatable

SINGAPORE– After undergoing surgical treatment to eliminate an overactive thyroid in 2014, video games designer and publisher Xeo Lye had jokingly asked his medical professional for how long he could endure without thyroid hormonal agent replacement tablets “in the event of a zombie apocalypse”. He was offered one year.

” I was told that my body functions will gradually close down if I did not take my hormone tablets. I will ultimately slip into a coma and die. Well, it seems like I ‘d still have a long time to butcher a few zombies along the way,” stated the 38-year-old games with a laugh.

A decade-long struggle with Graves’ illness, an autoimmune condition that triggers his own antibodies to assault the thyroid, has actually not moistened his outlook.

Mr Lye eliminated the whole gland as his condition was so severe that it could not be effectively controlled with regular treatment. An examination had likewise spotted a nodule in his thyroid which was potentially cancerous.


In conjunction with Thyroid Awareness Month, Mr Lye shared his experience to raise awareness of thyroid disorders.

Detected in 2004, he had actually initially associated early indications of the illness– problems falling asleep and hand tremblings – to the stress of trading in the United States Options market. The hand tremblings became too apparent to dismiss. Sleep eluded him and his immune system went haywire. Common moderate health problems like stomach flu ended up being hard to handle. Once, he took 6 months to recuperate from a viral fever.

Mr Lye’s “super strong” thyroid likewise practically killed him in 2011 when it went unto an overdrive after radioactive iodine (RAI) treatment that was meant to slow down his thyroid activity. The episode impacted his potassium levels, which caused muscle paralysis.

” Initially, I thought I had overworked my muscles after trying out skinny jeans on a shopping trip, which I considered a genuine workout,” he quipped. “The cramps got worse and by the time I got to the (health center’s) emergency department, I might not feel my limbs. I didn’t understand how severe the episode was up until I gained from the doctor that I was well on my way to a heart attack.”


The thyroid is a butterfly-shaped gland in the neck that affects metabolic processes. If it breakdowns, it will wreak havoc on a host of body functions consisting of guideline of heart rate and rhythm, weight, brain activity and energy production.

Professionals estimate that approximately 5 to 10 per cent of the population struggles with a thyroid disorder.

It is presently uncertain why some person’s thyroids or body immune systems malfunction.

Research shows genetic factors may be involved. A research study published in Hormone and Metabolic Research study in 2011 discovered that children and brother or sisters of autoimmune thyroid diseases victims have a 16-fold and 15-fold – increased threat of developing the conditions, respectively. Research studies have actually also revealed that if an identical twin agreements Graves’, the other twin has a higher possibility of getting it too.

Thyroid conditions, which can occur at any age, are also more common in ladies. They are about 5 times more typical in ladies than in males, stated Dr Goh Su-Yen, head and senior specialist of Singapore General Health center’s department of endocrinology.

A comparable trend is observed for thyroid cancer, which is 3 times more common in females than in men, said Dr Goh. Thyroid cancers are the eighth-most typical cancer in women but are not amongst the leading 10 cancers for guys, based on the 2010 to 2014 National Disease Computer registry report, she stated.

” However, this does not indicate that (thyroid disorders) are unusual in men. Both males and females can be affected by the exact same kind of thyroid conditions,” said Dr Vivien Lim, president of the Endocrine Metabolic Society of Singapore and endocrinologist at Gleneagles Healthcare facility.

Typical thyroid disorders vary from a bigger gland (known as a goiter) to the lethal cancer. They likewise include Tomb’ disease (which triggers the thyroid produces too much thyroid hormonal agents), Hashimoto’s thyroiditis (which causes the thyroid to produce insufficient hormonal agents) and thyroid including nodules, stated Dr Lim.


Early indications of a thyroid condition may not be apparent. For instance, signs of an underactive thyroid might develop gradually over a number of years, depending upon the intensity of the hormone shortage, stated Dr Goh.

” You might hardly observe symptoms such as fatigue and sluggishness, which might at first seem to be simply part and parcel of growing older. The signs become more apparent as your metabolism continues to slow,” said Dr Goh.

While both genders experience similar symptoms, particular signs are more commonly seen in males.

If the thyroid condition is serious, it may cause impotence, stated Dr Lim. Periodic paralysis– attacks of muscle weakness– is more typical in guys with Tomb’ disease, said Dr Goh. The condition may be fatal if the breathing muscles or heart are impacted.

Men and smokers with Tomb’ likewise have the tendency to experience a more serious type of eye symptom, referred to as Tomb’ orbitopathy, she added. This happens through irritated eye muscle and tissue, which can cause the eyeballs to appear to protrude from their sockets.

Muscle paralysis and eye symptoms, Mr Lye likewise developed an uncommon skin condition called pretibial myxedema, which triggered scaling and swelling on his ankle. “The medical professional was so stunned and excited by it because it was so uncommon in Singapore it just existed in medical literature,” he stated.


Inning Accordance With Dr Lim, many thyroid conditions are extremely treatable. In hyperthyroidism for instance, oral medications are able to control the symptoms and lower thyroid hormonal agent production. When oral medications do not work, there are other alternatives such as radioactive iodine, she stated.

Those with a sluggish thyroid are usually treated with hormonal agent replacement therapy. This involves using artificial thyroid hormone pills that control the patient’s thyroid hormonal agent levels and normalises metabolism, said Dr Goh.

Outcomes for early-stage thyroid cancers appear favorable too.

“It depends upon the patient’s age and how advanced the cancer is however I constantly inform clients that if I were to select one cancer to have, it would be (thyroid cancer), given that it is rather slow-growing and the 10-year survival rates are high, when detected early,” said Dr Lim.

Some thyroid clients look for alternative or complementary therapies, such as supplements, Conventional Chinese Medicine, together with treatments recommended by their doctors.

While such alternative therapies are usually safe, there is little proof to show they are effective, stated Dr Nitish Mishra, a professional in endocrinology and specialist at Raffles Diabetes and Endocrine Centre. He cautioned against changing traditional medical treatment with such treatments.

“The threat is that their thyroid condition will worsen, and they might need emergency situation admission beyond a specific threshold. When it comes to thyroid cancer, there is a potential for the illness to spread out if conventional medical treatment is delayed,” he stated.

Clients who want to use alternative treatments should also consult their doctors before beginning any alternative therapy.

Mr Lye needs hormone replacement therapy for life, he has no remorses getting rid of his “mutant” thyroid.

“My sister, who has a much milder form of Graves’ illness, said I was foolish to (remove my thyroid). For me, it feels as if a curse has actually finally been raised,” he stated.

A study released in Hormonal agent and Metabolic Research study in 2011 found that kids and brother or sisters of autoimmune thyroid diseases victims have a 15-fold and 16-fold- increased danger of developing the conditions, respectively. If the thyroid condition is extreme, it may cause erectile dysfunction, stated Dr Lim. Periodic paralysis– attacks of muscle weakness– is more common in guys with Graves’ illness, stated Dr Goh. According to Dr Lim, a lot of thyroid conditions are extremely treatable. In hyperthyroidism for example, oral medications are able to control the signs and minimize thyroid hormone production.