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Medication • Propranolol 40mg tab

• Lanoxin 0.25mg tab
• PTU(Propylthiouracil) 5mg tab
• Tranexamic acid 10mg IV

Exercise One may suffer from shortness of breath and intolerance to exercise
when one first starts an exercise schedule. So it is best to first start
doing low impact cardiovascular exercises. It is best to start doing
physical exercises like walking, rowing, swimming and bicycling. It is
best to stop once one is tired of exercising and not overdo it.

Next it is best to avoid too heavy exercises like lifting of weights.

These exercises may increase ones body metabolism and may also
lead to high blood pressure. One’s physician is to best person to
advice you when you can start training on heavy weights.

Besides it is not good to take up exercising for long periods if one is

a victim of hyperthyroidism. One should make it a point to take rests
at periodic intervals. It is also necessary that one takes longer
warm-up and cool down sessions to allow the body’s metabolism to
come back to normal.

The heart rate of a person with hyperthyroidism takes much longer

to come back to normal. Including deep breathing and relaxation
exercises help to strengthen the weak respiratory muscles of the
person. Yes, deep breathing and relaxation exercises for about ten
minutes during the cool down session does help the body to come
back to the resting and normal state gradually.

To end, one can definitely be fit when affected by hyperthyroidism if

one takes care of ones diet, medications and exercise patterns.

Treatments • Surgical Removal of the Gland or Nodule

Radioactive iodine is the most widely-recommended
permanent treatment of hyperthyroidism
For patients with sustained forms of hyperthyroidism,
such as Graves' disease or toxic nodular goiter, anti-
thyroid medications are often used.
Health Teachings • Exercise regularly with planned rest and periods

• Set realistic goals to increase activity as tolerated

• Avoid strenuous activities

• Take anti- thyroid medication as instructed at the same time

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each day

• Obtain permission from physician for the over-the-counter

medications

• Keep follow-up appointments with physician

• Avoid warm environment

• Avoid pressure or irritation to the skin to prevent skin

breakdown

• Avoid excess stress, which increase metabolic rate

• Use medical alert bracelet or card

Outpatient
• Care after initiation of antithyroid medications includes the
following:
o After 4-6 weeks, antithyroid medications usually must
be reduced; otherwise, the patient becomes
hypothyroid. Hypothyroidism causes the usual
symptoms of fatigue and weight gain, but in patients
with Graves disease, it has been anecdotally associated
with worsening of thyroid ophthalmopathy.
o Initially, the patient should have thyroid function tests
performed every 4-6 weeks until thyroid levels are
stabilized on a low dose of antithyroid medication.
Perform follow-up tests of thyroid function at least
every 3 months for the first year. After 12-18 months,
stop antithyroid medication or decrease it in patients
with Graves hyperthyroidism to determine if the patient
has gone into remission.
o Non–Graves hyperthyroidism rarely has remissions.
Once a patient with Graves hyperthyroidism becomes
euthyroid on oral antithyroid medication, consider
other definitive treatment, such as radioactive iodine
therapy. A significant fraction of patients with Graves
disease go into remission, and most eventually, over
many years, become hypothyroid from autoimmune
destruction of the gland.
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• Care after radioactive iodine ablation includes the following:

o Ablation of the gland occurs over several (4-5) months
after the therapy. Most patients become hypothyroid.
Checking thyroid functions every 4-6 weeks until they
stabilize is recommended.
o Once the thyroid hormone levels start falling into the
low-normal range, stopping antithyroid medications
and considering starting a low dose of thyroid hormone
replacement before the patient becomes hypothyroid is
reasonable; however, some prefer to document
persistently elevated TSH values off antithyroid
medication before starting thyroid hormone
replacement. Starting with partial or low-dose thyroid
hormone replacement is recommended (25-50 mcg/d
and adjusted every 6-8 wk to normalize the TSH level).
Starting with full replacement doses when TSH first
becomes elevated after131 I therapy leads to a higher
incidence of hyperthyroidism due to overreplacement.
o After131 I therapy, patients can in rare cases become
thyrotoxic due to vigorous thyroid destruction and
release of preformed hormone. Also, radioablation can
cause the release of thyroid antigens and exacerbate
the autoimmune thyroid disease process. When the
former happens, it often is accompanied by a painful,
radiation-induced thyroiditis that can be treated with
nonsteroidal anti-inflammatory medication or
glucocorticoids.
• Care after subthyroidectomy or other thyroid surgery includes
the following:
o Most patients remain euthyroid after a lobectomy or
lobectomy plus isthmusectomy. Obtain thyroid function
tests 3-4 weeks postoperatively after a lobectomy to
ensure normal thyroid function.
o After subtotal thyroidectomy for hyperthyroidism and
cessation of antithyroid therapy, most patients become
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hypothyroid, depending on how much functional tissue

is left by the surgeon.
o After a subtotal thyroidectomy, partial replacement
(T 4 , 50-75 mcg/d) is recommended, to begin shortly
after surgery. Monitor thyroid function tests 4-8 weeks
postoperatively, and adjust the T4dose to maintain a
normal TSH level.

Diet 1. Hamburger Thyrotoxicosis- Thyroid hormones are orally

active, which means that consumption of thyroid gland tissue can
cause thyrotoxicosis, a type of hyperthyroidism. Several
outbreaks of thyrotoxicosis have been attributed to a practice, now
banned in the US, called "gullet trimming", where meat in the neck
region of slaughtered animals is ground into hamburger. Because
thyroid glands are reddish in color and located in the neck, it's not
unusual for gullet trimmers to get thyroid glands into hamburger or
sausage. People, and presumably pets, that eat such hamburger can
get dose of thyroid hormone sufficient to induce disease.

2. Avoid Aspartame. Aspartame is the technical name for the

brand names NutraSweet, Equal, Spoonful, and Equal-
Measure. It was discovered by accident in 1965 when James
Schlatter, a chemist of G.D. Searle Company, was testing an anti-
ulcer drug.

I often receive emails from women, asking about aspartame- an

artificial sweetener usually used in diet coke and other products.
We are often concerned about our weight and there is a steady
tendency of substituting regular white sugar with artificial
sweeteners. I personally, never did that. Partially because never had
weight problems, and partially because I just don't like the taste of
artificial sweetener.

The exact mechanism of acute reactions to excess free glutamate

and aspartame is currently being debated. As reported to the FDA,
those reactions include:(5)

* Headaches/migraines

* Nausea

* Abdominal pains

* Fatigue (blocks sufficient glucose entry into brain)

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* Sleep problems

* Vision problems

* Anxiety attacks

* Depression

* Asthma/chest tightness.

3. Avoid drinking Diet Coke or any other diet products, if you

suffer from Hyperthyroidism- they cause more harm than
benefits, because of the chemicals and artificial substances in it.

4. Avoid foods with high iodine content, such as sea food.The

full list of some of the foods with their iodine content to help you
determine what to include in your Hyperthyroidism diet and
what not you can find here:

Sexuality/Spirituality
• Adhere as closely as possible to your prescription
regimen. Even slight discrepancies in your schedule can lead
to thyroid fluctuations that may throw your entire system off
balance.

• Maintain a healthy diet and fitness routine. This will

help you combat fatigue, improve your self-confidence, and
keep your metabolism in check.

• Discuss sexual symptoms frankly and matter-of-factly

with your doctor if they arise. It may feel awkward, but
physicians are trained to listen to patients’ concerns without
passing judgment -- it’s their job. Nipping the problem in the
bud as soon as it arises is always the best thing you can do.

• Consider supplementing your thyroid medication with

additional hormone treatments. These can help balance
the fluctuations that can wreak havoc on your sex drive and
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performance. Your doctor can help you decide if this is the

best option for you.

• If the problem is persistent, consider couples

counseling. It may be difficult for your partner to understand
that a drastic change in sex drive or performance isn’t a
personal rejection. A licensed helping professional may offer
the support you both need to work through this sensitive
issue in a positive, healthy way.

>Consider Therapy

When there are other psychological and self-esteem issues

preventing healthy sexual desire, therapy can sometimes help.

>Psychotherapy and Spiritual Therapy. This will not only treat

your physical ailment but it is a very effective for your mind and
soul. It has been said that a mind that is free from all negative
thoughts is the best treatment for overall health problems.

> Get in Touch. It is very important that when you are suffering
from any kind of body ailment, you should not suffer alone. You
should see to it that you are in touch with other people who are also
suffering the same problem. You can discuss all the things
concerning your condition. By doing this you will be enlightened
and relieved.

>Support Groups. Try to get in touch with other people who have
the same problem as you. By supporting each other, it will be easier
to accept the body ailment that is affecting you.