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Scott Benner 0:00
Hello friends, and welcome to episode 640 of the Juicebox Podcast.

In this the seventh installment of the defining thyroid series, Jenny Smith and I will define thyroiditis. So far in the defining thyroid series, we've tackled hypothyroidism, and Hashimotos thyroiditis. That's an episode 616. In Episode 619, we define pituitary and thyroid glands. In Episode 624, we defined P S H testing, and in Episode 628, we define T four and T three. In episode 632. We talked about auto immune episode 636 was goiter, and today in Episode 640 thyroiditis. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin?

If you have type one diabetes, or are the caregiver of someone with type one, and are a US resident, please go to T one D exchange.org. Forward slash juicebox. And take the survey. This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitor, learn more and get started today@dexcom.com forward slash juicebox. It's at that very link that you'll be able to say hello to Dexcom. Let's define thyroiditis

Jennifer Smith, CDE 2:09
I was checking off. So I remember which of these as well. I'm sure you probably

Scott Benner 2:13
Well, I I appreciate that we've known each other long enough that you're not 100% sure if I'm doing it so that you're handling it to which I really appreciate. Thyroid is is interesting because my wife has hypothyroidism my daughter's had it for years. My son has Hashimotos now and until I met Dr. BENITO nobody ever said the words thyroiditis to me ever. And she used it so much. While she was talking to us that I thought Well, this must be important because she has said it a number of times. Can you tell me what it is?

Jennifer Smith, CDE 2:48
It's the swelling, right? Just swelling of the thyroid gland. Correct? Yeah. And which can either cause high or low levels of the thyroid hormones kind of into the bloodstream or in circulation. That's my general idea of what thyroiditis and I mean, itis is really inflammation. So that's anything that ends in itis is an inflammatory type of condition. Okay.

Scott Benner 3:15
Interestingly enough around this because I don't think there's a ton to talk about around this. When when she was saying it, I I had no like I said, I had no context and I jumped a thyroid storm, in my mind in my head for some reason. But those are not the same thing. No, right. So I'm going to blend those two here together just because why not keep my confusion together. thyroid storm also referred to as a thyrotoxic crisis is an acute life threatening hypermetabolic state induced by excessive release of thyroid hormones, T H s in individuals with thyroid toxicity, Tyro Toxis store, thyroid storm may be the initial presentation of thyroid Toxis. I know I'm not saying that right. firerock thyroid talk. Holy God,

Jennifer Smith, CDE 4:12
is it there? Is it there a toxic Kosis Is there a sea of courses? Yes, yes. thyrotoxicosis.

Scott Benner 4:18
If I were gonna say that word, thyroids. I'll do it again, thyroid store and maybe the initial presentation of thyroid toxicosis in undiagnosed children. Okay. All right. So a thyroid storm, is I didn't realize this is much more serious than thyroiditis, thyroiditis is inflammation. thyroid storm is is a real like legitimate problem. That's interesting. So these are just words you may hear while you're talking about your thyroid issues in the doctor's office, and I didn't want people like I don't think they're like, I don't think thyroid thyroiditis and thyroid storm are things that you're going to need to know day to day while you're managing your thyroid issues. But I don't want you to be in the situation I was in where I was sitting there with a dumb look on my face gone. Uh huh, uh huh, uh huh. Yeah, sure, sure. Yeah, thyroid is right.

Jennifer Smith, CDE 5:12
Once every storm from what I know, is very, it's rare. Yeah. Right. That is not a it's not, you know,

Scott Benner 5:20
it's not likely something you're going to see. But I think it's I do think it's a phrase that people know. Because, yes, I know it. Then other people have to know because I'm not like, you know, I mean, prior to this, I wasn't digging around for words like that. And I remember when I said it the first time privately, Dr. BENITO was like, no, no, no, she put her hand up like it was COVID time. So we were talking through video, she put her hand up, she was that is not the same thing. And I was like, Oh, well, there goes me sounding like I know what I'm talking about. But I just wanted to have them here in the series, because, you know, I think you're going to hear them. And if you do, you should.

Jennifer Smith, CDE 6:00
Well, and I. Yeah, I was gonna say in in from what I remember about just the term thyroid storm, which again, I think it's a general enough term that some people may not know enough about it or may misunderstand, from what I know about it, just the general it's much more relative to treatment, that has not gone the right way for Graves disease. Okay. I believe, again, rare as it is, if you're treating hyperactive thyroid with what they it's like a, it's like a radioactive iodine that's used. It can result in thyroid storm. But that's again, it's rare to happen. So it's not something to be concerned if that's the therapy that they're going to use for your greatest disease. But it can occur I

Scott Benner 6:58
see. Yeah, because it's saying here that your heart rate your blood pressure, your body temperature can all soar to dangerously high levels during a thyroid storm. So this is not something that people who just have hypothyroidism or hyperthyroidism are gonna see this this is yeah, very specifically very specific. Yeah, to you. Oh, wow. That's really crazy. While the symptoms are insane, fever, sweating, vomiting, diarrhea, delirium, severe weakness, seizures, irregular heartbeat, yellow skin, jaundice. Yeah, this is not I want to be clear, this is not something that most any of you are going to run into. If you have it, it's good to

Jennifer Smith, CDE 7:37
clear up what it is to be able to say, you know, definitively, you're very likely, you're more unlikely to have this ever happened to you. But this is what it is just in case somebody, you know, sort of strangely uses the term and you're like, I don't know, I don't know exactly what that is.

Scott Benner 7:55
I'll tell you the one thing that switching back to thyroiditis, when Dr. BENITO was talking to us about it privately, you know, Arden had a swing in her health at one point, and she kind of the doctor kind of couldn't figure out what it was a couple years. Okay. And she just said, Well, this just might be thyroiditis, and we're gonna have to wait for it to pass and calm and like she almost made it sound like you know, you can get a swelling of you know, and it can happen. It says the, the most common cause of thyroiditis. Some of the agents known to cause thyroiditis are antibodies. This is the most common cause drugs, radiation organisms like viruses or bacteria, conditions in which the body attacks itself, or autoimmune disease. thyroiditis can be an autoimmune disease while we know that, but the way she made it sound was like, well, maybe Arden just had a virus and it and her thyroids acting up because of it. And we'll we'll get on top of it with medication, retest her later and see if we can move we'll move the medication back when it's time. That could I guess that, you know, for most people, I mean, I really love bringing this up, because I'm a very strange person. I don't have a thyroid issue. And I am really enjoying talking about this. But but it's because you

Jennifer Smith, CDE 9:09
live, you live with enough thyroid issues. Right?

Scott Benner 9:13
I did I know how important it is to really understand it so that you can see what's happening around you and make adjustments. And moreover, because of my job, and the amount of people I see who have, you know, some sort of hyper hypothyroidism Graves disease who live in this in this bubble. I see how many people are not managing it well, don't understand it and are struggling very needlessly and correct. That's why I wanted to do this because it's just, it's just it's not it's this tiny little pill, you take it once a day. It's not that hard, you know, and it's a huge help for

Jennifer Smith, CDE 9:49
you. I think the hard thing is finding somebody who can manage that medication well for you and that the other hard part is paying close enough attention to your own body. You know, when something is not right anymore, that you can say, you know, my meds have been working really great. Everything's been in line, Hey, Doc, I'm getting this symptom back or I've got this like new and it's just sort of started and otherwise I feel okay, but this is not right. So it's always important to bring up anything that doesn't seem right once medications are well managed, because it could mean that something has changed. And you may need more or less.

Scott Benner 10:28
Jenny is doing a great job of getting us ready to talk about the next topic. Very good, Jenny, that's awesome. Look at you just segwaying away. Seriously, you should put this on your CV. Thinking

Jennifer Smith, CDE 10:40
about doing that. It's just what was in my mind in terms of our context.

Scott Benner 10:45
But it works, because the next thing we're going to talk about is how to treat your thyroid. So you did Oh, all right. Awesome. Thank you. I'll talk to you soon. Yeah. Cool. I think you should put podcaster on your CV.

Jennifer Smith, CDE 10:57
I think, you know, I actually I probably should, I mean, I've done this enough with you. I mean, that I probably

Scott Benner 11:04
really good. I like to see it on your I want to see it on there. Let's get it in.

Before I tell you about the sponsor Dexcom. I'd like to thank you for listening to the defining thyroid series. It's not over yet. There are a few more episodes, but I'm getting a crazy amount of positive feedback from the listeners. And I appreciate it. This is a little bit of a departure from the diabetes stuff. But I thought it was really important. And I'm glad you're enjoying it. You can say hello to dexcom@dexcom.com forward slash juice box. I'm going to give you an example a real life example of something that's going on in our house right now. So my daughter has to be on a steroid pack for six days. And as you will know, if you've ever tried to take steroids, and you have type one diabetes, those steroids can make your blood sugar go up significantly. And with my daughter, they tried, but I knew I was going to combat it with a significant Basal increase. But that's a scary thing to do, isn't it? Right? As an example, my daughter's Basal is 1.1 An hour during the day, right now. And I didn't know how much I was going to have to increase it. So what do I do? Well, I use the data that was coming back from the Dexcom to make adjustments almost in real time to Ardens. Basal needs to know how much she ended up needing per hour to combat those steroids. four units an hour, I can tell you right now, that without seeing my daughter's blood sugar in real time, right in front of me on my phone, I would never have had the nerve to go from 1.1 to four. But that ends up being what she needed. And I was assisted by the data that came back from the Dexcom G six. That is just one example of how having that constant feedback of blood sugar data is valuable. I mean, just imagine the same situation, but a growth spurt. Or maybe some female hormones are in play. You can make adjustments and see their impacts in real time. You can see your blood sugar on the Dexcom receiver or on an iPhone or an Android phone. That was a big help to me today. Being able to see my daughter's blood sugar's when she wasn't with me when I sent her off to school with a Basal rate that was four times normal. That gave me a lot of pause. But I felt comfortable because a I knew it was working. It had been working for a number of hours at home and be I knew if something went crazy, I'd see it right on my phone. And I'd be able to do something about it right away. The Dexcom G six shows you what your blood sugar is. It shows you what direction it's moving if it's moving, and it tells you how quickly it's moving in that direction. This information is of key importance dexcom.com Ford slash juice box. These are my results. Yours may vary of course. But I'm going to tell you right now, the speed, direction and number of your blood sugar right there on your phone. There's nothing like it. There are links in the show notes of your podcast player, and links at juicebox podcast.com. For Dexcom. And all of the sponsors. When you click on the links, you're supporting the show, head over now and say hello to Dexcom dexcom.com forward slash juicebox. Thank you so much for listening to this episode of The Juicebox Podcast. I'll be back very soon, with much much more

If you're wondering what signs and symptoms to look for in hypothyroidism, hyperthyroidism, Graves' disease and Hashimotos I'm going to list them all for you right now. If you already know what they are. Well then thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast, but if you're waiting for the signs and symptoms they're gonna happen like right now. symptoms of hypothyroidism Farey the Mayo Clinic list of possible symptoms as fatigue, increased sensitivity to cold constipation, dry skin weight gain, puffy face, hoarseness, muscle weakness, elevated blood cholesterol level, muscle aches, tenderness and stiffness, pain stiffness or swelling in your joints heavier than normal or irregular menstrual periods. thinning hair slow heart rate depression impaired memory enlarged thyroid gland, which could be known as a goiter. If you're looking for this in infants, you might also look for a large protruding tongue difficulty breathing, hoarse, crying, an umbilical hernia, or yellowing of the skin and whites of the eyes. As the disease progresses in infants, you may also notice constipation, poor muscle tone and excessive sleepiness. In teens, you may notice poor growth resulting in short stature, delayed development of permanent teeth, delayed puberty or poor mental development. Let's move on to hyperthyroidism. Still on the Mayo Clinic's website, they say of course, that hyperthyroidism can mimic other health problems. We've been talking about this through all these episodes, you know that unintentional weight loss even when your appetite and food intake stay the same or increase, rapid heartbeat, irregular heartbeat, pounding of your heart, increased appetite, nervousness, anxiety, and irritability. Tremors usually a fine trembling in your hands or fingers, sweating changes in menstrual patterns. increased sensitivity, heat, changes in bowel patterns, especially more frequent bowel movements, and enlarged thyroid gland of course called a goiter, which may appear a swelling at the base of your neck, fatigue, muscle weakness, difficulty sleeping, skin thinning, find embrittle hair. For Graves disease, you're looking for dry eyes, red or swollen eyes, excessive tearing or discomfort in one or both eyes, light sensitivity, blurred or double vision, inflammation or reduced eye movement, protruding eyeballs. Just quickly Hashimotos disease which as we know is an autoimmune version of hypothyroidism. Hashimotos disease progresses slowly over the years you may not notice signs or symptoms of the disease. Eventually the decline in thyroid hormone production can result in any the following. There gonna be a lot of duplicates here from hypothyroidism, fatigue and sluggishness, increased sensitivity to cold increase sleepiness, dry skin, constipation, muscle weakness, muscle aches, tenderness and stiffness, joint pain and stiffness, irregular or excessive menstrual bleeding, depression, problems with memory or concentration, swelling of the thyroid, the goiter of puffy face, brittle nails, hair loss, enlargement of the tongue. I'd like to just finish by saying that if you have any of these, please see a doctor get a simple blood test and get yourself some answers. Don't forget a TSH over two is enough reason to be concerned. Treat your symptoms, not the lab values. Thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast.