Dr. Katie S. Payne, MD

Treatment for most asthma patients involves three steps. Patients learn what their asthma triggers are and avoid them. They take a daily control medication, usually an inhaled corticosteroid, to reduce inflammation in the lungs. Also, they have rescue medication with them at all times to take in case of a severe attack. These quick-acting inhaled medications relax the muscles around the airways and allow the lungs to open up for air.

There is no cure for asthma, but with treatment it should not interfere with daily life and activities.

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.

Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.

Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.

The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.

Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.