Hyperthyroidism Linked to Stroke

By Todd Neale, Staff Writer, MedPage Today Published: April 01, 2010 Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Action Points Explain to interested patients that this study could not establish a causal relationship between hyperthyroidism and ischemic stroke, although there was an association between them. Point out that, although the risk of stroke was relatively higher in patients with hyperthyroidism, the absolute risk was still low at 1%. Younger adults with hyperthyroidism appear to have an increased risk of ischemic stroke, a Taiwanese study showed. Adults younger than 45 who had the thyroid disorder were 44% more likely to have an ischemic stroke over a five-year period than their healthy peers (HR 1.44, 95% CI 1.02 to 2.12), according to Herng-Ching Lin, PhD, of Taipei Medical University in Taiwan, and colleagues. Still, the absolute risk of stroke remained low, affecting just 1% in those with hyperthyroidism and 0.6% in the comparison group, the researchers reported online in Stroke: Journal of the American Heart Association. "Our results indicate a need for thyroid function testing and detection of hyperthyroidism in surveys to identify the etiology of ischemic stroke in young people," they wrote. Although case reports or case series have suggested a link between hyperthyroidism and cerebrovascular disease, Lin and colleagues noted, an overactive thyroid has never been considered a stroke risk factor for young adults. To explore the issue, the researchers analyzed data from the Longitudinal Health Insurance Database in Taiwan, which has a universal healthcare system. They identified 3,176 patients younger than 45 (mean age 32) who were treated for hyperthyroidism and compared them with 25,408 healthy controls matched by age, gender, and year of index ambulatory care visit. Through five years of follow-up, 0.7% of the patients had ischemic strokes -- 1% of those with hyperthyroidism and 0.6% of the controls (P=0.028). The elevated risk of ischemic stroke in patients with hyperthyroidism remained significant after adjustment for age, gender, income, level of urbanization, hypertension, diabetes, atrial fibrillation, hyperlipidemia, coronary heart disease, geographical region, and use of antiarrhythmics. The mean and median times from the index ambulatory visit to the onset of ischemic stroke were 983 and 1,004 days, respectively, in those with hyperthyroidism. "Our study indicates hyperthyroidism and antithyroid therapy may be associated with shortterm and long-term cerebrovascular consequences," Lin and colleagues wrote. "These results are in accordance with previous studies suggesting that hyperthyroidism and radioiodine therapy are associated with increased long-term vascular risk." The study could not establish a causal relationship between hyperthyroidism and ischemic stroke. However, there are some plausible mechanisms by which one condition could increase the risk of the other, according to the researchers. "There are hypercoagulability, hypofibrinolysis, and endothelial dysfunctions in

hyperthyroidism, and all may contribute to the increased risk of thromboembolism," they wrote. Reference: http://www.medpagetoday.com/Endocrinology/Thyroid/19348

Jazzmin Angel R. Comaling 2B1-BSN Subclinical Hyperthyroid Increases Mortality Risk in Elderly
Thursday, June 16, 2011 - Byron Richards, CCN Weekly Health Podcast An Italian study of 965 adults age 65 and older has found that those withsubclinical hyperthyroid1 had a 65% chance of increased mortality from any cause in a six-year study period. Of particular concern is that 9% of the population tested had this problem, indicating that many elderly people could be at risk. Subclinical hyperthyroid means that their resting metabolic rate is simply going too fast. In healthy aging, the metabolic rate actually slows down a little bit to help pace the rate of metabolism to accommodate the aging process. Going too fast places stress on the heart, bones, brain, and general overall health. Symptoms may be somewhat subtle and so not easily recognized and may include a racing heart or abnormal heart rhythm, anxiety or easy irritability, or trouble sleeping. Since these wired up type symptoms can be caused by other issues this type of problem can go unrecognized. On lab tests it means that the TSH (thyroid stimulating hormone) will be low while the T3 and T4 are still in the normal range. The absence of a TSH signal indicates the lack of a TRH signal, which is the signal going from the hypothalamus gland to the pituitary to initiate thyroid production in the normal way. TRH does many things in the brain besides stimulating the production of TSH. It is a major anti-inflammatory compound that helps the glial cells reduce brain inflammation. It also helps coordination, meaning that another symptom of subclinical hyperthyroidism is worsening coordination/balance that would increase the risk of a fall. Depression of TRH indicates a highly inflammatory condition, especially in the brain. As is typical, the medical profession would have no logical explanation or treatment for this issue. If it was actually on their radar they would likely come up with eradication of the thyroid gland in whole or in part as their remedy. The solution is to reduce inflammation in the brain so that the TRH and TSH signaling can normalize. In this situation, almost any nutrient that helps reduce inflammation would likely help, especially nutrients that help reduce inflammation in the brain. Blueberries, grape seed extract, resveratrol, fisetin, magnesium, and DHA would be top choices. Reference:

http://www.wellnessresources.com/health/articles/subclinical_hyperthyroid_in creases_mortality_risk_in_elderly/