The Butterfly Effect

Miss Chua Kia Min was just 18, when a church friend, who's also a doctor, spotted something amiss.

She noticed her slightly protruding eyes and trembling hands, and advised Miss Chua to get it checked.

The then-polytechnic student was diagnosed with hyperthyroidism, a condition where her thyroid gland was producing more energy- and metabolism-regulating hormones than needed.

"I felt tired but presumed it was normal, especially since I was still in school then," she says.

Anxiety was an issue for her as well.

The more anxious she felt, the faster her heart would palpitate.

"Before sleeping at night, I could literally hear my heart beating."

Now she's about to turn 24 and has been living successfully with the condition for the past six years, thanks to pills she takes daily.

According to Dr Daniel Wai, a consultant endocrinologist from Daniel Wai Diabetes, Thyroid And Hormone Clinic, thyroid conditions are the most common complaint doctors in his field treat.

Sufferers tend to fall between the ages of 20 and 50. Women are eight times more likely to have it and many of them develop the condition after childbirth.

With 5 per cent of the local population estimated to have it, the genetic disorder may be more prevalent than one imagines. In the worst case scenario, an untreated thyroid condition, in conjunction with other health problems, may result in death.

The thyroid is a butterfly-shaped gland located near the front of the lower neck. It secretes hormones which regulate the body's energy levels and metabolism.

The hormones affect the following:

  • Digestive system, appetite and weight
  • Heart rate
  • Respiration
  • Perspiration
  • Muscle and nerve function
  • Mood
  • Menstrual cycle

When the thyroid does not produce enough hormones, an autoimmune condition known as hypothyroidism (or in layman terms, an "underactive thyroid") results.

More common among Chinese, Malays

And when the opposite happens - more hormones are produced than required - hyperthyroidism (an overactive thyroid) ensues.

Dr Loh Keh Chuan of Loh Keh Chuan Diabetes, Thyroid & Hormone Clinic suggests genetics have a role to play.

The endocrinologist says that hyperthyroidism is more common among the Chinese and Malays.

Hypothyroidism, on the other hand, is predominant in the Indian community.

Dr Loh has seen patients with unusual symptoms, such as a severe itch, swelling in the ankles, acute abdominal pain and sudden paralysis.

In the last scenario, patients are immobile as potassium flows from one part of the body to another. But they recover spontaneously after several hours.

While the illness may run in the family, Dr Eng says it is not hereditary.

Environmental factors like stress are also possible triggers, he says.

And as autoimmune illnesses like thyroid conditions go, once you're diagnosed with it, other autoimmune illnesses like diabetes tend to surface, say doctors.

But treatment is readily available.

Drugs, radioactive iodine or surgery are all possible options. A common misconception which patients have is that consuming more iodine can improve their hypothyroidism condition, says Dr Wai.

He overturns this notion with an anecdote.

"I had a patient who wasn't responding to treatment. Later, I found out her mum cooked her seaweed (rich in iodine) soup every day."

He says: "We already have iodine in our salt. Taking extra does not help."

This article was first published in The New Paper.