“Hypothyroidism happens when the thyroid gland doesn’t make enough thyroid hormone. This condition also is called underactive thyroid. Hypothyroidism may not cause noticeable symptoms in its early stages. Over time, hypothyroidism that isn’t treated can lead to other health problems, such as high cholesterol and heart problems.”

MAYO CLINIC (Hypothyroidism (underactive thyroid) – Symptoms and causes – Mayo Clinic)

Hypothyroidism Statistics Today:

• Prevalence: Hypothyroidism affects over 30 million Americans, with a prevalence of 11.7% in 2019.

• Demographics: Women are 5 to 9 times more likely than men to have hypothyroidism. 

• Undiagnosed Cases: Up to 60% of hypothyroidism cases in the U.S. go undiagnosed. 

Dr. CHILDS (50 Hypothyroidism Statistics: The State of Thyroid Patients [2024])

Part II Thyroid Awareness Month – Hypo and Hyper thyroidism.

Hypothyroidism:

This occurs when your thyroid produces too little thyroid hormone, a condition that is often linked to iodine deficiency.

Dr. David Brownstein, a board-certified holistic practitioner who has been working with iodine for the last two decades, claims that over 95 percent of the patients in his clinic are iodine-deficient.

In addition, 10 percent of the general population in the United States, and 20 percent of women over age 60, have subclinical hypothyroidism,² a condition where you have no obvious symptoms and only slightly abnormal lab tests.

However, only a marginal percentage of these people are being treated. The reason behind this is the misinterpretation and misunderstanding of lab tests, particularly TSH (thyroid stimulating hormone). Most physicians believe that if your TSH value is within the “normal” range, your thyroid is fine. But as I always say, the devil is in the details. More and more physicians are now discovering that the TSH value is grossly unreliable for diagnosing hypothyroidism.

How to Know If You Have Hypothyroidism

Identifying hypothyroidism and its cause is tricky business. Many of the symptoms of hypothyroidism are vague and overlap with other disorders. Physicians often miss a thyroid problem since they rely on just a few traditional tests, leaving other clues undetected.

The most sensitive way to find out is to listen to your body. People with a sluggish thyroid usually experience:

Lethargy – Fatigue and lack of energy are typical signs of thyroid dysfunction. Depression has also been linked to the condition. If you’ve been diagnosed with depression, make it a point that your physician checks your thyroid levels.Some of the obvious signs of thyroid fatigue include:

• • It’s essential to note that not all tiredness or lack of energy can be blamed on a dysfunctional thyroid gland. Thyroid-related fatigue begins to appear when you cannot sustain energy long enough, especially when compared to a past level of fitness or ability. If your thyroid foundation is weak, sustaining energy output is going to be a challenge. You will notice you just don’t seem to have the energy to do the things like you used to.
• • Feeling like you don’t have the energy to exercise, and typically not exercising on a consistent basis
  • A heavy or tired head, especially in the afternoon; your head is a very sensitive indicator of thyroid hormone status
  • Falling asleep as soon as you sit down when you don’t have anything to do
• Weight gain– Easy weight gain or difficulty losing weight, despite an aggressive exercise program and watchful eating, is another indicator.
• Rough and scaly skin and/or dry, coarse, and tangled hair– If you have perpetually dry skin that doesn’t respond well to moisturizing lotions or creams, consider hypothyroidism as a factor.
• Hair loss– Women especially would want to pay attention to their thyroid when unexplained hair loss occurs. Fortunately, if your hair loss is due to low thyroid function, your hair will come back quickly with proper thyroid treatment.
• Sensitivity to cold– Feeling cold all the time is also a sign of low thyroid function. Hypothyroid people are slow to warm up, even in a sauna, and don’t sweat with mild exercise.
• Low basal temperature – Another telltale sign of hypothyroidism is a low basal body temperature (BBT), less than 97.6 degrees Fahrenheit averaged over a minimum of three days. It is best to get a BBT thermometer to assess this.                                                                              

“The thyroid gland is a small, butterfly shaped organ located in the base of the neck, just below the Adam’s apple. It plays a crucial role in regulating the body’s metabolism, heart rate, and temperature. The thyroid produces two main hormones, triiodothyronine (T3) and thyroxine (T4), which are essential for various bodily functions. These hormones are produced in the thyroid follicles, which are filled with colloid, a sticky fluid that contains iodine. The thyroid gland’s health is vital for the overall well-being of the body, influencing the function of many organs, including the heart, brain, liver, kidneys, and skin.“

Cleveland Clinic (Thyroid Disease: What It Is, Causes, Symptoms & Treatment)

There is an alarming number of people in America that have issues with their thyroid, in fact it’s a huge number, around 59 million people suffer from a thyroid problem. A thyroid handles your metabolism and is a gland located in the neck area. It can have huge negative affects on your health if it is not treated properly. Many people aren’t even aware that they have any symptoms that are connected with a thyroid; but before going into the problems lets first talk about what the thyroid is.

The Anatomy & Physiology of the Thyroid Gland:

The thyroid is a small gland, measuring about 2 inches (5 centimeters) across, that lies just under the skin below the Adam’s apple in the neck. The two halves (lobes) of the gland are connected in the middle (called the isthmus), giving the thyroid gland the butterfly shapes organ, sort of looking like a bow tie. Normally, the thyroid gland cannot be seen and can barely be felt. If it becomes enlarged, doctors can feel it easily, and a prominent bulge (goiter) may appear below or to the sides of the Adam’s apple.

How the Thyroid Gland Works:

• The thyroid is part of the endocrine system, which is made up of glands that produce, store, and release hormones into the bloodstream so the hormones can reach the body’s cells. The thyroid gland uses iodine from the foods you eat to make two main hormones:
• Triiodothyronine (T3)
• Thyroxine (T4)

T4, the major hormone produced by the thyroid gland, has only a slight effect, if any, on speeding up the body’s metabolic rate. When this occurs instead, T4 is converted into T3, the more active hormone. The conversion of T4 to T3 occurs in the liver and other tissues. Now yes T3 is made by the thyroid but if too much in the body it is converted to T4, more inactivating or decreasing your T3 levels to prevent metabolism too high in the body causing metabolic problems.  Many factors control the conversion of T4 to T3, including the body’s needs from moment to moment and the presence or absence of illnesses.

In a nut shell the thyroid gland is the gland that releases hormones that plays an impact on metaboloism = the way your body uses energy. The thyroid’s hormones regulate vital body functions.

Two Thyroid Hormones made and released by this organ that impact your metabolism=Triiodothyronine-also known as T3 and T4-also known as thyroxine.

It is important that T3 and T4 levels are neither too high nor too low but within normal range of therapeutic levels. Two glands in the brain—the hypothalamus and the pituitary communicate to maintain T3 and T4 balance.

The Hypothalamus:

A structure deep in your brain, acts as your body’s smart control coordinating center. Its main function is to keep your body in a stable state called homeostasis. It does its job by directly influencing your autonomic nervous system or by managing hormones. and one of the organs it affects is the THYROID.

The pituitary gland:

This organ sometimes called the “master” gland of the endocrine system because it controls the functions of many of the other endocrine glands. The pituitary gland is no larger than a pea, and is located at the base of the brain. The gland is attached to the hypothalamus by nerve fibers and blood vessels (a part of the brain that affects the pituitary gland). The pituitary gland itself consists of 2 major structures:

• Anterior lobe – this is where TSH is produced and released.
  
• Posterior lobe

This is how the hypothalamus and the pituitary gland work:

The Hypothalamus produces and releases Thyroid Releasing Hormone when T3 & T4 are low in the blood.             The Pituitary produces and releases Thyroid Stimulating Hormone TSH to  tell your thyroid how much thyroid hormone it needs to make.

The hypothalamus senses low circulating levels of thyroid hormones (T3 & T4) and responds by releasing thyrotropin-releasing hormone (TRH). The TRH stimulates the pituitary telling it to produce thyroid-stimulating hormone (TSH) and causing the following effect in the body:

• When T3 and T4 levels are low in the blood, the pituitary gland releases more of TSH to tell the thyroid gland to produce more thyroid hormones.
• If T3 and T4 levels are high, the pituitary gland releases less TSH to the thyroid gland to slow production of these hormones.  The inhibiting release of TRH and TSH through a negative feedback loop.

T3 and T4 travel in your bloodstream to reach almost every cell in the body. The hormones regulate the speed with which the cells/metabolism work. For example, T3 and T4 regulate your heart rate and how fast your intestines process food. So if T3 and T4 levels are low, your heart rate may be slower than normal, and you may have constipation/weight gain. If T3 and T4 levels are high, you may have a rapid heart rate and diarrhea/weight loss.

Did you know the third hormone produced by the thyroid gland is called calcitonin. Calcitonin is made by C-cells. It is involved in calcium and metabolism of the bone only.

“Why the urgency? Glaucoma, often called the silent thief of sight, is a leading cause of irreversible blindness in the United States, yet as many as half of the people who have it don’t know they are affected.

Glaucoma is not just one disease. It is a group of eye conditions that damage the optic nerve, the cable that sends visual information from your eye to your brain. Most types of glaucoma are linked to high intraocular pressure, although some people develop glaucoma without it.

A 2024 meta-analysis estimated that about 4.22 million adults in the United States have glaucoma, and more than 1.4 million already have vision loss from the disease. Globally, glaucoma affects an estimated 80 million people, a number expected to rise as populations age.”

Glaucoma Research Foundation (Don’t Let The Silent Thief Steal Your Sight: January Is Glaucoma Awareness Month – Glaucoma Research Foundation)

If you are diagnosed with glaucoma, it is important to set a regular schedule of examinations with your eye doctor to monitor your condition and make sure that your prescribed treatment is effectively maintaining a safe eye pressure.

Treatments

The Treatment of Glaucoma: The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially in you catch the disease in its early stage. The goal of glaucoma treatment is to lower pressure in your eye (intraocular pressure). Depending on your situation, your options may include eyedrops, laser treatment or surgery. 

Remember The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially in you catch the disease in its early stage. The goal of glaucoma treatment is to lower pressure in your eye (intraocular pressure). Depending on your situation, your options may include eyedrops, laser treatment or surgery.

Eyedrops

Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes. Depending on how low your eye pressure needs to be, more than one of the eyedrops below may need to be prescribed.

Prescription eyedrop medications include:

• Prostaglandins. These increase the outflow of the fluid in your eye (aqueous humor), thereby reducing your eye pressure. Medicines in this category include latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan) and latanoprostene bunod (Vyzulta). Possible side effects include mild reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or eyelid skin, and blurred vision. This class of drug is prescribed for once-a-day use.
• Beta blockers. These reduce the production of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples include timolol (Betimol, Istalol, Timoptic) and betaxolol (Betoptic). Possible side effects include difficulty breathing, slowed heart rate, lower blood pressure, impotence and fatigue. This class of drug can be prescribed for once- or twice-daily use depending on your condition.
• Alpha-adrenergic agonists. These reduce the production of aqueous humor and increase outflow of the fluid in your eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan P, Qoliana). Possible side effects include an irregular heart rate, high blood pressure, fatigue, red, itchy or swollen eyes, and dry mouth. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.
• Carbonic anhydrase inhibitors. These medicines reduce the production of fluid in your eye. Examples include dorzolamide (Trusopt) and brinzolamide (Azopt). Possible side effects include a metallic taste, frequent urination, and tingling in the fingers and toes. This class of drug is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.
• Rho kinase inhibitor. This medicine lowers eye pressure by suppressing the rho kinase enzymes responsible for fluid increase. It is available as netarsudil (Rhopressa) and is prescribed for once-a-day use. Possible side effects include eye redness, eye discomfort and deposits forming on the cornea.
• Miotic or cholinergic agents. These increase the outflow of fluid from your eye. An example is pilocarpine (Isopto Carpine). Side effects include headache, eye ache, smaller pupils, possible blurred or dim vision, and nearsightedness. This class of medicine is usually prescribed to be used up to four times a day. Because of potential side effects and the need for frequent daily use, these medications are not prescribed very often anymore.

Because some of the eyedrop medicine is absorbed into your bloodstream, you may experience some side effects unrelated to your eyes. To minimize this absorption, close your eyes for one to two minutes after putting the drops in. You may also press lightly at the corner of your eyes near your nose to close the tear duct for one or two minutes. Wipe off any unused drops from your eyelid.

If you have been prescribed multiple eyedrops or you need to use artificial tears, space them out so that you are waiting at least five minutes in between types of drops.

Oral medications

If eyedrops alone don’t bring your eye pressure down to the desired level, your doctor may also prescribe an oral medication, usually a carbonic anhydrase inhibitor. Possible side effects include frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney stones.

Surgery and other therapies

Other treatment options include laser therapy and various surgical procedures. The following techniques are intended to improve the drainage of fluid within the eye, thereby lowering pressure:

• Laser therapy. Laser trabeculoplasty (truh-BEK-u-low-plas-tee) is an option if you have open-angle glaucoma. It’s done in your doctor’s office. Your doctor uses a small laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks before the full effect of this procedure becomes apparent.
• Filtering surgery. With a surgical procedure called a trabeculectomy (truh-bek-u-LEK-tuh-me), your surgeon creates an opening in the white of the eye (sclera) and removes part of the trabecular meshwork.
• Drainage tubes. In this procedure, your eye surgeon inserts a small tube shunt in your eye to drain away excess fluid to lower your eye pressure.
• Minimally invasive glaucoma surgery (MIGS). Your doctor may suggest a MIGS procedure to lower your eye pressure. These procedures generally require less immediate postoperative care and have less risk than trabeculectomy or installing a drainage device. They are often combined with cataract surgery. There are a number of MIGS techniques available, and your doctor will discuss which procedure may be right for you.

After your procedure, you’ll need to see your doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise again or other changes occur in your eye.

“The Vision and Eye Health Surveillance System (VEHSS) modeled estimates of Glaucoma are CDC’s primary estimates of the prevalence of glaucoma in the United States.

“VEHSS used a statistical model to combine multiple sources of data available in VEHSS to produce these estimates.

In 2022, an estimated 4.2 million Americans of all ages were living with glaucoma, including 1.5 million people with vision-affecting glaucoma. Non-Hispanic Black people had the highest crude prevalence rate of glaucoma (1.97%) and vision-affecting glaucoma (0.74%). Females had higher prevalence rates than males for glaucoma (1.36% vs. 1.17%) and vision-affecting glaucoma (0.48% vs. 0.41%).”

Center for Disease Control and Prevention – CDC (VEHSS Modeled Estimates: Prevalence of Glaucoma | Vision and Eye Health Surveillance System (VEHSS) | CDC)

“Glaucoma is a leading cause of vision loss and blindness in the United States. But as many as half of people with glaucoma don’t know they have it.

Glaucoma has no early symptoms. The only way to check for it is to get a comprehensive dilated eye exam. There’s no cure for glaucoma, but starting treatment as early as possible can help stop vision loss.

Anyone can get glaucoma, but some people are at higher risk, including people who:

• Are over age 60
• Are Black/African American and over age 40
• Are Asian American
• Are Hispanic/Latino
• Have a family history of glaucoma”

National Eye Institute (Glaucoma Awareness Month | National Eye Institute)

A common eye condition in which the fluid pressure inside the eye rises to a level higher than healthy for that eye. If untreated, it may damage the optic nerve, causing the loss of vision or even blindness. The elderly, African-Americans, and people with family histories of the disease are at greatest risk.

Glaucoma is a multi-factorial, complex eye disease with specific characteristics such as optic nerve damage and visual field loss. While increased pressure inside the eye (called intraocular pressure or IOP) is usually present, even patients with normal range IOP can develop glaucoma.

There is no specific level of elevated eye pressure that definitely leads to glaucoma; conversely, there is no lower level of IOP that will absolutely eliminate a person’s risk of developing glaucoma. That is why early diagnosis and treatment of glaucoma is the key to preventing vision loss.

Eye pressure is measured in millimeters of mercury (mm Hg). Normal eye pressure ranges from 12-22 mm Hg, and eye pressure of greater than 22 mm Hg is considered higher than normal. When the IOP is higher than normal but the person does not show signs of glaucoma, this is referred to as ocular hypertension.

High eye pressure alone does not cause glaucoma. However, it is a significant risk factor. Individuals diagnosed with high eye pressure should have regular comprehensive eye examinations by an eyecare professional to check for signs of the onset of glaucoma.

A person with elevated IOP is referred to as a glaucoma suspect, because of the concern that the elevated eye pressure might lead to glaucoma. The term glaucoma suspect is also used to describe those who have other findings that could potentially, now or in the future, indicate glaucoma. For example, a suspicious optic nerve, or even a strong family history of glaucoma, could put someone in the category of a glaucoma suspect.

Vision loss from glaucoma occurs when the eye pressure is too high for the specific individual and damages the optic nerve. Any resultant damage cannot be reversed. The peripheral (side) vision is usually affected first. The changes in vision may be so gradual that they are not noticed until a lot of vision loss has already occurred.

In time, if the glaucoma is not treated, central vision will also be decreased and then lost; this is how visual impairment from glaucoma is most often noticed. The good news is that glaucoma can be managed if detected early, and with medical and/or surgical treatment, most people with glaucoma will not lose their sight.

Most common signs and symptoms of Glaucoma:

There are several forms of glaucoma; the two most common forms are primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG). Open-angle glaucoma is often called “the sneak thief of sight” because it has no symptoms until significant vision loss has occurred.

Types of Glaucoma:

1-Open Angle Glaucoma

2-Angle Closure Glaucoma

3-Normal Tension Glaucoma

Open-angle glaucoma, the most common form of glaucoma, accounting for at least 90% of all glaucoma cases:

• Is caused by the slow clogging of the drainage canals, resulting in increased eye pressure
• Has a wide and open angle between the iris and cornea
• Develops slowly and is a lifelong condition
• Has symptoms and damage that are not noticed.

“Open-angle” means that the angle where the iris meets the cornea is as wide and open as it should be. Open-angle glaucoma is also called primary or chronic glaucoma. It is the most common type of glaucoma, affecting about three million Americans.

Symptoms of Open-Angle Glaucoma

There are typically no early warning signs or symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years.

Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease.

By the time a patient is aware of vision loss, the disease is usually quite advanced. Vision loss from glaucoma is not reversible with treatment, even with surgery.

Because open-angle glaucoma has few warning signs or symptoms before damage has occurred, it is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventative treatment to help protect your vision.

In open-angle glaucoma, the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye’s drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve. It is the most common type of glaucoma, affecting about four million Americans, many of whom do not know they have the disease.

You are at increased risk of glaucoma if your parents or siblings have the disease, if you are African-American or Latino, and possibly if you are diabetic or have cardiovascular disease. The risk of glaucoma also increases with age.

Angle-closure glaucoma, a less common form of glaucoma:

• Is caused by blocked drainage canals, resulting in a sudden rise in intraocular pressure
• Has a closed or narrow angle between the iris and cornea
• Develops very quickly
• Has symptoms and damage that are usually very noticeable
• Demands immediate medical attention.

It is also called acute glaucoma or narrow-angle glaucoma. Unlike open-angle glaucoma, angle-closure glaucoma is a result of the angle between the iris and cornea closing.

Symptoms of Angle-Closure Glaucoma

• Hazy or blurred vision
• The appearance of rainbow-colored circles around bright lights
• Severe eye and head pain
• Nausea or vomiting (accompanying severe eye pain)
• Sudden sight loss

Angle-closure glaucoma is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure. This is a much more rare form of glaucoma, which develops very quickly and demands immediate medical attention

In contrast with open-angle glaucoma, symptoms of acute angle-closure glaucoma are very noticeable and damage occurs quickly. If you experience any of these symptoms, seek immediate care from an ophthalmologist.

If you are diagnosed with glaucoma, it is important to set a regular schedule of examinations with your eye doctor to monitor your condition and make sure that your prescribed treatment is effectively maintaining a safe eye pressure.

3-Normal-tension glaucoma

Tomorrow stay tune for part II on glaucoma awareness giving other types of glaucoma, how its diagnosed & the risks.