Natural radiation and thyroid disease N Nicolas Petrini-Woolley · 2018-12-01 · icolas...

thyrobulletin, Autumn 2000 1

Volume 21, No. 3 Autumn 2000

Thyroid Foundation of Canada

t h y r o b u l l e t i nLa Fondation canadienne de la Thyroïde

con't page 2

Natural radiation and thyroid diseaseicolas Petrini-Woolley is a 13-year old grade eight student atEganville District Public

School, in Eganville, Ontario. Nicolaswas a participant in the National ScienceFair in London, Ontario, May 2000, andhe returned home sporting a gold medaland $2,900 in awards and scholarships.His project, Natural radiation andthyroid disease, earned top honours in thejunior division of the Earth and Environ-mental studies category.

With the first-place finish came a goldmedal and a $400 prize. His project alsoearned him a $500 Special EnergyAward, for an outstanding project on theenvironment, as well as a $2,000scholarship to the University of WesternOntario in London, Ontario.

So what is next for this youngresearcher? He intends to apply for entryinto the 2001 International Science Fairto be held in San Jose, California. Nicolaswants to add a new stage to his alreadycompleted work: the study of radon gasin homes, well-water and the environ-ment.

Extract reprinted with permission fromthe Eganville Leader, Eganville, Ontario.

Background and purposeMy science project, Natural radiation

and thyroid disease, was started severalyears ago on the basis of two criticalitems. One was fact and one was localfolk lore. The fact was that mycommunity has abundant uranium andother radioactive material in the naturalenvironment. The folk lore was that mycommunity has higher rates of certaindiseases. I began considering that eventhough the radioactive deposits inRenfrew county are small and not of

byNicolas Petrini-WoolleyN

commercial significance, perhaps theywere of public health significance. If youwere unfortunate enough to build yourhome on a uranium/thorium source andwere not aware of the potential problemfor radon gas, your health could be at risk.I became more concerned when my bestfriend learned that his mother haddeveloped thyroid disease and that he hadradon gas in his basement. So, in Part Iof my Radiation Project I looked at theenvironment of individuals with thyroiddisease and breast cancer. I found a higherlevel of radioactivity in the environmentof individuals with thyroid disease. Now,in Part II, I have increased the number ofcases investigated and I am looking solelyat individuals with low thyroid disease.The thyroid gland produces criticalchemicals that control our bodies’functioning. Under very controlledcircumstances, Iodine 131 is used

medically to slow down an overactivethyroid gland. Iodine 131 does this mainlyby beta particles and gamma rays. Thisraises the possibility that beta particlesand gamma rays produced by naturalradiation could cause a person with anormal thyroid to become hypothyroid(low thyroid function) after exposure tonatural radiation for a long period of time.Therefore, I only chose individuals whohad lived in their homes for at least tenyears before developing thyroid disease.This was an investigative field experi-ment.

HypothesisThere is a connection between

natural radiation and thyroiddisease.

Field work, method and materialsThe two instruments I used to do my

research are a Radiation Detector and aReconnaissance Scintillometer. TheRadiation Detector is calibrated withCesium 137 and is sensitive to alpha, beta,and gamma radiation. The Recon-naissance Scintillometer was useful forrapid scans to detect gamma rays fromuranium and thorium. In this investigativeexperiment I have examined theenvironment of 20 people with lowthyroid function who have lived in theirhomes for at least ten years prior todeveloping thyroid disease. I have alsotested 5 control cases for comparison. Ineach location, four ten-minute beta andgamma radiation counts were taken, twowith the Radiation Detector and two with

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Natural radiation . . . con't from page 1

the Reconnaissance Scintillometer. Anormal background count was taken oneach day. Geological Radioactivity Mapsfrom the Ministry of Northen Mines andDevelopment were utilized.

Discussion of experiment

A) Experimental resultsMy data shows twice the level of

natural radiation in the environment ofpeople with hypothyroidism as comparedto control cases. Background radiationwas accounted for and numerousvariables were minimized. I onlyinvestigated people who had lived in theirhomes for at least ten years beforedeveloping thyroid disease. I also onlychose individual cases with low thyroidfunction. Low thyroid function would bea more likely result of natural radiationexposure. This year I used a Recon-naissance Scintillometer to help scan anarea prior to doing a count with theRadiation Detector. The nature of ‘in situ’testing makes for more variables due tolack of control of the source. The resultsof these 20 cases continue to imply anassociation between thyroid disease andnatural radiation worth investigatingfurther.

B) New DiscoveryAn unexpected result of my field work

has become very important. I havediscovered a potential uranium/thoriumsource not previously identified. PamSangster, the Resident Geologist for theMinistry of Northern Development andMines, is very interested in my results. Ageologist will be coming to take rock fromthe Eganville samples for this possibleuranium/thorium source. The reason thisis important is that where there is thoriumor uranium, there is a higher likelihoodof finding radon gas. Radon gas is knownto be a problem in the home of case #13which is also where the uranium/thoriumsource was found.

Radon gas is a potent alpha particleemitter and when inhaled in known tocause lung cancer. Case #13 is directlyacross the Bonnechere River from aknown highly radioactive area. New in-depth airborne gamma ray studies will bedone this summer focusing on my studyarea. I hope to obtain research funding topurchase 50 radon gas detectors. Then inPart III of my radiation project I plan to

focus on radon gas, in Sebastopol,Grattan, and Wilberforce Townships.With the help of Public Health I hope tocorrelate known lung cancer in thesetownships with known areas ofradioactivity. Dr. Robert Shives, the Headof the Geophysics Section of NaturalResources Canada and a radon gas expertfelt this would be a very worthwhileproject. He is interested and supportiveof this project.

C) Experiment SummaryThis experiment has helped me to learn

how to form a hypothesis, examine thefacts, devise an experiment, doexperimental field work, use scientificmethod to arrive at a conclusion. I alsolearned the physics of the atom,radioactive decay and what a PeriodicTable is. I have become aware of thepotential health hazards of naturalradiation and the relationship betweenexposure to increased levels of naturalradiation for prolonged periods of timeand thyroid disease. The discovery of auranium/thorium source near homes withknown radon gas has lead tounderstanding radon gas and itssignificance. Radiation Part III will be aRadon Gas Project and has the potentialto be of significant importance to publichealth.

Conclusion

My hypothesis that there is aconnection between natural

radiation and thyroid disease issupported by my experimental

results.

Future project Radiation Part III1. I plan to gather information on radon

testing in homes, well-water, and theenvironment.

2. Then I will write letters to the specifictownships involved, the EganvilleRotary club, Natural ResourcesCanada, Environment Canada, andthe Ministry of Northern Develop-ment and Mines to obtain funding for50 radon gas testers.

3. I will start the radon gas project inDecember, 2000, because winter isthe best time to test homes for radongas.

4. Geologists will be coming in the nextmonth to do rock sampling on mynew discovery. They will also bedoing more detailed airborne mapsover our area this summer. PamSangster, the resident geologist willbe coming specifically to my test areaand wants to meet with me.

5. I intend to overlap locations of peoplewith known possible health problemsfrom radon gas, with areas of knownradioactivity. Public Health hasoffered me their support and help inthis matter. I am very excited aboutthis project and I think it has markedpublic health significance.

AcknowledgmentsI want to thank the following for their

support

1. Dr. M. Corriveau, who is the MedicalOfficer of Health for the RenfrewCounty and District Health Unit.

2. Pam Sangster, who is the RegionalGeologist for the Ministry ofNorthern Development and Mines.

3. Robert Shives, who is the Head ofRadiation Geophysics Section, forthe Mineral Resources Division ofNatural Resources Canada.

4. Ken Ford, a geologist in airbornesection of Geological Survey ofCanada.

5. Last I want to thank my father, a ruralFamily Physician in Renfrew Countyfor 20 years. He was always ready todiscuss thyroid disease and naturalradiation with me. He also helped meidentify the cases to be studied.

National OfficeChristmas hours

The office will be closed fromThursday

December 21st, 2000at 4:30 pm

toTuesday

January 2nd, 20019:00 am


President’s message Message de la présidenten behalf of the ThyroidFoundation of Canada, I wouldlike to extend our congratu-

lations to Nicholas Petrini-Woolley on hisoutstanding achievement. Nicholas is anextraordinary young student whoresearched the possible correlationbetween natural radiation and thyroiddisease and won a gold medal at theNational Science Fair. We wish him wellon his next project. We are very proud tohelp promote the fact that our youngpeople are indeed making our world abetter one.

As we approach the holiday season andthe third millennium, I would like to takethis opportunity to wish each and everyone of you our very best wishes for goodhealth, happiness and prosperity.

Remember your Foundation duringthis gift-giving season! While looking forthe perfect gift for a friend or a loved one,think of a gift membership and/or adonation in their name to TFC to helpfurther our Education & ServicesPrograms.

Irene Britton/Irène BrittonNational President/Présidente nationale

O D

My storyby

Gloria Davis

or many months I was feelingvery tired, aching joints, bowelproblems, dry skin and hair. Over

the next year I was seen by two specialistsand one family doctor in my area. Theone specialist did bowel and throat scopesand then removed my gall bladder. Icontinued to feel worse. Blood tests weredone (for what I am not sure) but I doknow I was now being looked upon as ifmy problem was ‘mental’. None of thedoctors felt my throat area.

Finally I was sent to a specialist outsidemy area who immediately felt my throatand told me I had a large growth on mythyroid gland. The letter of introductionthat I took to this doctor from my areaspecialist said in part: “this is a 62-yearold woman who claims to be sick but doesnot look sick!!” Next I was referred to

another specialist who ordered a needlebiopsy. The report came back that I had alarge cancerous tumour on the thyroidgland. What followed was a nightmare.

I entered the hospital and had a ‘veryaggressive total thyroidectomy’. Aftertwo weeks in the hospital I wasdischarged. On the way home on thefreeway, in heavy traffic, I suffered atetany attack from low blood calcium andhad to be rushed to Emergency as mybody was twisting up into a pretzel state.Next on the list were many scans andmore cancer clinic appointments. I thenhad an iodine drink and more scans. I wasput into isolation for three days forradioactive iodine. My cancer had spreadand I had to have 20 radiation treatmentsfor my throat area. I lost my voice for sixweeks. Radiation left me weak and dizzy.A CT scan was ordered and it was nowrevealed I had a brain aneurysm. Isurvived brain aneurysm surgery whilealso dealing with cancer. My ear drumcollapsed and I am still left with an

F

impaired sense of balance. My voice isstill limited, I can no longer sing as it is amonotone. I am now 68-years old andentering my sixth year of cancer check-ups and testings for my Synthroidmedication.

What I have learned from all this is:educate yourself about your bodies,especially, if you are a middle-agedwoman as so many doctors write us offas a ‘mental problem’. They do not reallylisten to what we are saying. Go with alist and be firm until the problem is found.

If my sharing this can help one personavoid thyroid cancer, then it will be worthit. From the Foundation’s literature andwhat I bring up on the Internet, my cancerwas advanced when finally found.Hopefully I will not be in the 5% that donot survive the 5-10 year span. I havebeen told that I am a survivor, seeing allthe above happened to me in less than atwo year period.

Gloria Davis lives in Chilliwack, BC

\\

Give the gift that helps! Donnez le don qui aide!

e la part de La Fondationcanadienne de la Thyroïde,félicitation à Nicholas Petrini-

Woolley pour sa realization except-ionnelle. Nicholas est un jeune étudiantextraordinaire, qui a reçu une médailled’or à la foire nationale des sciences, pourses recherches sur la possibilité d’unecorrélation entre les radiations naturelleset les maladies thyroïdiennes. Nous luisouhaitons bonne chance pour sonprochain projet. Nous sommes très fierde promouvoir le fait que nos jeunes gensaident en effet, à améliorer notre mondeentier.

A l’approche du temps des fêtes et dutroisième millénaire, je souhaite à tous età toutes mes meilleurs voeux de bonnesanté, de bonheur et de prospérité.

N’oubliez pas votre fondation durantcette période d’abondance! Pendant vosrecherches du cadeau idéal pour un amiou un proche, pensez donc d’offrir uneadhésion et/ou un don à la FCT en leurnom; cela nous aidera grandement à faireprogresser nos programmes d’éducationet de services.


Thyroid Foundation of CanadaLa Fondation canadienne de la Thyroïde

Founded in/Fondée à Kingston, Ontario, in 1980

Patron

Diana Meltzer Abramsky, CM, BA

Board of Directors

Founder – Diana Meltzer Abramsky (ON)President of each Chapter (currently 23)

President – Irene Britton (NB)Secretary – Shirley Penny (NF)Treasurer – Shirley Penny (NF)

Vice-PresidentsChapter Organization & Development – Joan DeVille (ON)

Education & Research – Lottie Garfield (ON)Publicity & Fundraising – Rod White (ON)

Operations – Venette Godbout (NB)Past President – Arliss Beardmore (BC)

Members-at-LargeMarc Abramsky, Ed Antosz, Ellen Garfield, Nathalie Gifford,

Marvin Goodman, Rita Wales

Annual Appointments

International Liaison – Diana Meltzer Abramsky, CM, BALegal Adviser – Shirley Penny (NF)

Medical Adviser – Robert Volpé, MD, FRCPC, MACP

Thyroid Foundation of Canada thanks Health Canada for its financial support.Thyroid Foundation of Canada is a registered charity

number 11926 4422 RR0001.La Fondation canadienne de la Thyroïde remercie Santé Canada pour son support

financier. La Fondation canadienne de la Thyroïde est un organisme debienfaisance enregistré numéro 11926 4422 RR0001.

ISSN 0832-7076 Canadian Publications Mail Product Sales Agreement #139122

thyrobulletin is published four times a year: the first week of May (Spring), August(Summer), November (Autumn) and February (Winter)

Deadline for contributions for next issue: December 15, 2000

Le thyrobulletin est publié quatre fois par année: la première semaine de mai(printemps), août (été), novembre (automne) et février (hiver).

La date limite pour les articles pour le prochain numéro: le 15 décembre, 2000

Contributions to/à – Editor/Rédacteur: Ed Antosz973 Chilver Road, Windsor ON N8Y 2K6

Fax: (519) 971-3694E-mail: [email protected]

• to awaken public interest in,and awareness of, thyroiddisease;

• to lend moral support tothyroid patients and theirfamilies;

• to assist in fund raising forthyroid disease research.

* * * * *

Les buts de laFondation sont:

• éveiller l’intérêt du public etl’éclairer au sujet des maladiesthyroïdiennes;

• fournir un soutien moral auxmalades et à leur proches;

• aider à remasser les fonds pourla recherche sur les maladiesthyroïdiennes.

The objectives of theFoundation are:

Thyroid Foundation of Canada

thyrobulletinLa Fondation canadienne de la Thyroïde

Please note:The information in thyrobulletinis for educational purposes only.It should not be relied upon for

personal diagnosis, treatment, orany other medical purpose. For

questions about individualtreatment consult your

personal physician.

Notez bien:Les renseignements contenus

dans le thyrobulletin sont pourfins éducationelles seulement. On

ne doit pas s’y fier pour desdiagnostics personnels,

traitements ou tout autre raisonmédicale. Pour questionstouchant les traitements

individuels, veuillez consultervotre médecin.


Trois étapes contrôlent le fonctionnement de laglande thyroïde.

D’ABORD, une hormone libérée par l’hypothalamus serend à l’hypophyse (voir diagramme). Cette hormone signaleà l’hypophyse de libérer une autre hormone, la thyréostimuline(TSH).

ENSUITE, la TSH se déplace de l’hypophyse à la glandethyroïde. La TSH stimule la glande thyroïde à produire leshormones thyroxines (T4) et triiodothyronines (T3).

ENFIN, les hormones thyroïdiennes T4 et T3 sont libéréesde la glande thyroïde dans la circulation sanguine. La T4 etT3 touchent à tous les points de l’organisme et régularisent lavitesse à laquelle divers systèmes organiques fonctionnent.

L’hypothyroïdie est le résultat d’une sous-activité de la glandethyroïde, qui ne produit pas assez d’hormones thyroïdiennes pourpermettre à l’organisme de fonctionner normalement. Certainssymptômes de l’hypothyroïdie sont la fatigue, la prise de poidsinexpliquée et l’intolérance au froid. Le traitement del’hypothyroïdie est simple. Un médicament peut remplacer leshormones thyroïdiennes qui manquent à l’organisme.

L’importance de la glande thyroïdeLa glande thyroïde pèse à peine 30 grammes, mais cette

minuscule glande en forme de papillon située de chaque côtéde la trachée à un impact énorme sur la santé. Elle produit etsécrète les hormones thyroïdiennes qui ont une influenceprofonde sur chaque système organique, de la fréquence àlaquelle le coeur bat à la vitesse à laquelle on brûle les calories.Les hormones thyroïdiennes régularisent la digestion, lafréquence cardiaque, la température corporelle, les glandessudoripares, le système nerveux, l’appareil reproducteur et lepoids corporel. L’hypothyroïdie survient lorsque la glandethyroïdienne ne produit pas assez d’hormones pourrépondre aux besoins de l’organisme (glande thyroïdesous-active).

L’hypothyroïdie est-elle fréquente?L’hypothyroïdie est l’une des maladies les plus fréquentes

et les plus faciles à traiter. On estime qu’entre 700 000 et unmillion de Canadiens souffrent d’une sous-activité de la glandethyroïdienne. La maladie affecte les hommes et les femmes,et plus souvent après 40 ans.

La glande thyroïde – lefonctionnement de la glande

thyroïde

Les signes et symptômes de l’hypothyroïdie• lassitude • froid• prise de poids inexpliquée • cheveux secs• fatigue chronique • léthargie• lenteur intellectuelle • dépression• ongles cassants • cheveux clairsemés• voix rauque et profonde • nervosité

Non traités, les symptômes d’hypothyroïdie seront deplus en plus perceptibles et s’aggraveront. La glandethyroïde peut s’hypertrophier (goitre). Le patient devientdistrait et son processus mental peut ralentir. Avec le temps,des symptômes cardiovasculaires peuvent apparaître et les tauxde cholestérol peuvent s’élever.

Le retour à la normale – le traitementLe traitement de la sous-activité de la glande thyroïde est

simple et repose sur un médicament d’ordonnance appelélévothyroxine sodique. La lévothyroxine sodique, le nomgénérique du médicament untilisé pour traiter l’hypothyroïdieest l’un des médicaments d’ordonnance les plus prescrits auCanada. Le médicament est sans danger et ne provoquepractiquement pas d’effets secondaires si le patient prend ladose qui lui convient. La lévothyroxine sodique est offertedans une vaste gamme de doses pour répondre aux besoins dechaque patient. Diverses marques du médicament sontfabriquées par différentes compagnies.

Quelle est la dose qui me convient?Il est essentiel de déterminer la dose appropriée afin d’éviter

le sur-traitement ou le sous-traitement. Le médecin vous ferasubir des tests pour déterminer la dose qui vous convient lemieux. Lorsque vous aurez pris le médicament pendant quatreà huit semaines, votre médecin pourra vous faire passer unenouvelle épreuve sanguine pour confirmer que vous prenez labonne dose.

Quand me sentirai-je mieux?Quelques semaines après le début du traitement, les

symptômes devraient commencer à disparaître. Vousremarquerez peut-être une différence dans la façon dont vousvous sentez.... vous aurez peut-être un regain d’énergie.Pendant un certain temps, le médecin continuera peut-être àajuster votre dose afin de trouver celle qui vous convient lemieux.

Choses à se rappeler• N’arrêtez pas de prendre vos pilules parce que vous vous

sentez mieux... sinon, vos symptômes pourraient revenirgraduellement.

• Vous avez oublié de prendre une pilule? Ne vous en faitespas. Prenez tout simplement votre prochaine pilule commesi de rien n’était.

• Ne changez pas de marque de lévothyroxine sans en parlerau préalable à votre médecin. Il y a des différences entreles marques fabriquées par différentes compagnies.

• Si vous changez de marque, votre médecin peut refaire vostests sanguins pour s’assurer que vous recevez la mêmedose de médicament.

Voyez votre médecin dans les cas suivants:• Vous êtes allergique à des aliments ou à des médicaments.• Vous êtes enceinte ou vous avez l’intention de le devenir.• Vous allaitez.• Vous prenez d’autres médicaments d’ordonnance.


Lettersto thedoctor

Robert Volpé, MD,FRCPC, MACP,

Medical Adviser tothe Foundation

treat with thyroxine, and so do most ofmy colleagues. With that caveat, the restof the schema is quite acceptable

* * * * *

y mother-in-law has recentlybeen diagnosed with ‘lazythyroid’ (la tiroide vaga). I

was wondering why would her doctor usesuch a phrase? Is it the same ashypothyroid? Her symptoms are itchyskin and tiredness.

A ‘lazy thyroid’ should be construedas hypothyroidism.

* * * * *

am a member of the Foundation andI have some very interestinginformation to share with you. I had

a discussion with about 10 people in myoffice about hypothyroidism. As it turnsout, six of us have hypothyroidism. Also,all six of us have blood type O negative.The fact that all six of us are O negative(when only 7% of the population are Onegative) is amazing in itself, but the factthat all six of us are also hypothyroid!Coincidence?

There may be a slight statisticalrelationship between O red cells and thepresence of autoimmune disease.However, there is a much greater linkbetween other genes found in the bloodcells, namely the HLA system found inwhite blood cells. After all, these diseasesare genetic.

* * * * *

as anyone heard about theattached quote? Should I beasking my doctor to test me for

celiac disease? I have Hashimoto’s.“There has been a major research

breakthrough in the area of autoimmunedisease. Researchers have found that asignificant number of patients withautoimmune thyroid disease also haveceliac disease, an intestinal disorder.They’ve even found that in those whohave both celiac and thyroid disease,autoantibodies (i.e. thyroid antibodies)will disappear after three months of agluten-free diet. Is there a cure for someforms of autoimmune hypothyroidism?”

M

I

It has been known for a long time thatceliac disease, which is an intestinaldisorder causing lack of absorption ofmany foods, is an autoimmune disorderwhich is related genetically toautoimmune thyroid disease. There is nodirect connection between the twodisorders, as one does not cause theother. However, there is an increasedincidence of each disease with the otherbecause of a genetic overlap.

* * * * *

have great trouble knowing whatare normal values regarding thethyroid. In thyrobulletin , Spring

1999 you explained about this. Somenumbers were the following: 60-150nmol/L; 10-23 pmol/L and 0.7-2.1 nmol/L. In an article in the Autumnthyrobulletin, Larry Wood said thenumbers were 0.5 to 5.0. One of my testpapers says 0.2025 and another 0.20 -6.10 mu/l. You see my confusion. Can itbe explained to me?

I have had a very hard time with thisillness and easily get confused. I feel thatthis thing about the numbers doesn’t helpat all, maybe that is why my doctor isreluctant to talk to me.

Another big problem is my inabilityto sleep without medication. For years Ihave had some quite good help by takingElavil. My doctor is reluctant to continueprescribing it as it has caused anaddiction. I worry about not being ableto keep on getting it.

For total serum thyroxine the normalrange is 60-150 nmol/l. For the freethyroxine it is approximately 10-13 pmol/l. For total serum T3 (triiodothyronine)the range is between 0.7 and 2.1 nmol/l.The free T3 ranges between 2 and 5 pmol/l. The Thyroid Stimulating Hormone(TSH) values (which is what Larry Woodwas referring to, and the TSH is thestandard thyroid test) vary between 0.4and 5.0 mu/l.

All of these values vary a little bit fromlaboratory to laboratory, but in essencefall within the ranges mentioned.

As for the inability to sleep, this isunlikely to have any relationship to thethyroid status.

* * * * *

H

I

ach summer, starting in July, Itake groups on extended canoetrips. I add an iodine-compound

tablet to the water we use to ensure thatit is safe for drinking and cooking. Willthis additional iodine in the diet cause aproblem with one’s thyroid, and is itcontributing to the increased incidence ofthyroid disease? I have recently beendiagnosed with hypothyroidism.

Certainly the level of iodine in the dietplays a role in the incidence of thyroiddisease, particularly autoimmune thyroiddisease. Whether this patient took asufficient amount of iodine while on hercanoe trips is difficult to know. If she hasbeen taking thyroxine over thoseintervals, then it simply does not matter.If she was not on thyroxine at the time,then it is at least possible that it playedsome role in aggravating herautoimmune thyroid disease.

* * * * *

n the Spring 1999 issue ofthyrobulletin , in answer toquestions from Hamilton, Testing

# 7, you state that you treat once the TSHvalues have risen above 8 milliunits perlitre. I have been given a copy ofRecommended approach to ThyroidFunction Testing, issued by the OntarioMinistry of Health (MOH) in 1992. Itindicates that treatment does not startuntil the TSH is greater than 15. Pleaseexplain the different approach.

The recommended approach tothyroid function testing issued by theOntario Ministry of Health in 1992 isquite reasonable, with the exception thatI do not wait until the TSH has reached15 before treating with thyroxine. In myview, that is set too high, and I do notwait for the free thyroxine to become low,another difference I feel about treatment.When the TSH is above 8, and in thepresence of autoantibodies, I invariably

E

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Chapter coming eventsFree admission – everyone welcome

Renew your Membership now andbecome eligible for our Monthly Draw

Every month one lucky RenewingMember will receive a book

on thyroid disease.

Our June 2000 winner was:Geraldine Wright

Mississauga, Ontariowho chose

“Your Thyroid: A Home Reference”Wood, Cooper and Ridgway

Our July 2000 winner was:Mr. & Mrs. L’Heureux

Gloucester, Ontariowho chose

“Your Thyroid: A Home Reference”Wood, Cooper and Ridgway

Our August 2000 winner was:Marilyn Wilson

White Rock, British Columbiawho chose

“Your Thyroid: A Home Reference”

Wood, Cooper and Ridgway

Monthly Draw

Burlington-HamiltonLocation: Joseph Brant MemorialHospital, Bodkin Auditorium. FreeParking• Tuesday November 21, 7:30 pm. Dr.

Allan Hebb, Internist. Topic:Thyroid disease and the body .Displays 7:00 pm

For information call (905) 637-8387

KingstonLocation: Ongwanada ResourceCentre, 191 Portsmouth Avenue,Kingston• Tuesday November 21, 7:30 pm.

Alan Smith, Pharmacist, KingstonGeneral Hospital. Topic: Druginteraction in thyroid disease.


Kitchener-WaterlooLocation: The Community Room,Albert McCormack Arena, 500Parkside Drive , Waterloo• Tuesday, November 21, 2000, 7:30

pm., Dr. Ruth McManus ,Endocrinologist, London HealthCentre. Topic: Thyroid reaction andother medical conditions.

• Saturday, February 10, 2001, 2:00pm. David Rainham, MD, CCFP,Kitchener. Topic: Stress, health andhappiness, managing thyroidcondition. Thyroid informationtable: Michele Donnelly. KnollPharma Inc. representative.

• Tuesday, March 20, 2001, 7:30 pm.Dr. John Booth, Endocrinologist,McMaster Medical Clinic,Hamilton. Topic: TBA.


LondonLocation: London Public LibraryAuditorium, 305 Queens Avenue,London• Tuesday November 21, 7:30 pm. Dr.

Merrill Edmonds, Endocrinologist.Topic: Hypothyroidism

• Tuesday March 20, 2001, 7:30 pm.Dr. Ruth McManus , Endocrinol-ogist. Topic: Thyroid and otherdiseases: Thyroid and pregnancy/adrenal/diabetes...


MontrealPlans are underway for future meetingsand pharmacy awareness days. Forinformation about times and dates, orif we can help you, call (514) 482-5266

OttawaLocation: Auditorium, OttawaHospital, Civic Campus , CarlingAvenue• Tuesday, November 21, 2000, 7:30 pm.

Dr. Robert Dent, Endocrinologist,Weight Management Clinic, OttawaHospital, Civic Campus. Topic:Thyroid disease and weightmanagement.

• Tuesday January 16, 2001, 7:30 pm.Dr. Ron Sigal, Endocrinologist,Loeb Research Institute and OttawaHospital. Topic: The role ofcombination T3/T4 treatment inhypothyroidism.


Saint JohnThe Greater Saint John Chapter will

be holding a public education meetingin late March 2001. Watch your localpapers, listen to your radio station,watch the cable channel for actual date,time and location.

La section de Saint John se rencontreaprès la mi-mars, 2001, pour uneréunion éducative. Le publique est letrès bienvenu. Les journaux, la radio etla station cable télévision vousavertiront la date, l’heure et la locationde cette réunion.

Your membership in theFoundation expires on the datethat is printed on the address

label on your thyrobulletin.

Please use theMembership/Donation Form

on page 15.

You may renew early – and forone or two years! You will becredited with renewal on the

date that you are due to renew.

. . . Donations arealways welcome.

NOTICE TOALL MEMBERS


• frequency of urination, undue thirst• poor appetite and constipation• apparent gout• peptic ulcer or heartburn• inflammation of the pancreas• bone demineralization (osteoporosis)

and bone fracture.

Coincidental thyroid conditions canoccur in more than 25% of patients withHPT. Patients can occasionally manifestabnormal involuntary movement orabdominal pain. Routine bloodchemistries may show early diagnosisbefore symptoms have occurred. This isan advantage for patients since treatmentcan prevent disturbance in body function.Most associated conditions are improvedor cured by the treatment of HPT. Somepatients with HPT may be asymptomaticfor many years.

There is usually little to find onphysical examination, and when one caninfrequently feel a lump in the neck, thismay signify an underlying malignancy ofthe thyroid or parathyroid glands whichstill have a good outcome with treatment.

Surgical treatment

Curative treatment usually requires asmall surgical procedure by anexperienced parathyroid surgeonfollowing which the patient can usuallybe discharged after one night in hospital.Where a patient has become infirm,operative treatment, minimal as it is, maynot be possible.

In the surgical treatment, a relativelyshort incision is made transversely in thelower midline neck, and the parathyroidglands are then demonstrated. Usually, aparathyroid adenoma is removed and theother parathyroid glands are observed andchecked. Where all four glands areenlarged or abnormal, a subtotalparathyroidectomy is classically done inwhich half of an enlarged gland is leftbehind and three-and-a-half glands areremoved. In hyperplasia, currently the

con't page 9

Women’s Health Matters Forum & ExpoJanuary 19-20, 2001

South Building, Toronto Convention Centre

This two-day event, will present over forty interactive seminars featuring top medicalexperts as well as over 140 exhibits by companies, agencies and organizations atthe forefront of women’s health. Seminars will be offered throughout both days. TheThyroid Foundation of Canada is hosting a session on Women and Thyroids,presented by Dr. Jay Silverberg on Saturday, January 20th. For more information,call 416-323-6000 or visit www.womenshealthforum.org.

Start the year healthy – attend the Women’s Health Matters Forum & Expo,January 19 - 20, 2001. General admission $10 per day. Tickets at the door.

T

Facts about Hyperparathyroidismhe parathyroid glands areusually four minute glandsmeasuring about ½ cm. in

diameter, loosely adherent to the fourpoles of the thyroid gland, which controlthe level of calcium in the body. Themajor disease that affects these glands istheir enlargement and hormonaloveractivity of one or more of theseglands resulting in a condition calledhyperparathyroidism (HPT).

This disease state was first describedin 1925 by Dr. Felix Mandl of Viennawhose patient showed the evidence ofterminal advanced HPT characterized bymultiple bone fractures, loss of height,kidney stones and kidney failure. Recentimprovements in our ability to accuratelydiagnose HPT has permitted us toappreciate how people may havelongstanding undiagnosed chronic illnessdue to HPT that can be cured with simpleeffective surgical treatment. Ifuncorrected, HPT may lead to increasedmortality or the rare severe acuteparathyroid crisis or progressive ill health.

Etiology or cause

HPT is usually due (85%) to a solitarybenign tumour or adenoma frequentlyaffecting the right lower gland. Anovergrowth of all four glands calledhyperplasia also causes HPT (10-15%) aswell as a very rare (½-2%) cancer of theseglands.

Exposure to radiation or a congenitalfamilial disorder associated at times withother endocrine disturbances may be acause, but in the majority of people, thecause is unknown. In HPT there is anexcess of parathyroid hormone (PTH)which acts to break down bone and drawout calcium from bone which increasesthe level of calcium in blood and urine,all of which leads to a wide variety ofproblems. The diagnosis of HPT lies inthe detection of an elevated serum calciumand parathyroid hormone although thereare many other biochemical evidences ofHPT. Also helpful in localization of theaffected gland is the use of a Sestamibinuclear scan. Other radiological tests canbe done in HPT but are not as useful asthe nuclear scan.

Symptoms and signs

Symptoms of HPT include:

• fatigue (marked)• high blood pressure• “arthritis” or joint pain• depression and weakness• memory loss and confusion• kidney stones and apparent bladder

infection

byIrving B. Rosen, MD and

Robert Volpé, MD


enlargements are not quite as severe asthey once were permitting an even moreconservative preservation of parathyroidtissue. Occasionally, with persistence,recurrence or familial disorder, orhyperplasia associated with kidneydisease, a surgeon will do a totalparathyroidectomy and implant portionsof a parathyroid gland into a muscle.

There are certain current variationsoccurring in surgical treatment. Oneconsists of doing the procedure under alocal anaesthetic and using a nuclearprobe to remove the enlarged glands.Another is to use a video-assistedendoscope only requiring a small incisionin the neck area. These are interesting butare still in the process of evaluation.

Surgical success should be about 95to 98%. Failure is usually seen inhyperplasia since adenomas are usually100% successfully treated. Where apersistent or recurring case occurs andrequires surgery, then further investi-gation in the way of localization by theuse of sophisticated x-rays (MRI, CTscan) and venous x-rays as well asSestamibi scans may be requiredpreoperatively for localization.

The side effects for surgical treatmentare small. The patient postoperativelyusually requires a calcium supplement tosatisfy the bone’s hunger for calciumwhich can now be satisfied. In femalesin the post-menopausal time of life,calcium feeding may be continued andbecome part of a program for themanagement of post-menopausal osteo-porosis as well. Other than this, there isusually, initially, swelling of the neck,discomfort on swallowing which does notinterfere with eating, discomfort in theback of the neck, and these symptomswear off by about 4 to 6 weeks time.There is usually less than 1% possibilityof a change in the sound of the voice, andif this were to occur, it is usuallytemporary and corrects itself spon-taneously with the restoration of normalvoice in about 1 to 2 months time.

Medical management ofhyperparathyroidism

It is clear that the most appropriate wayto deal therapeutically with hyper-parathyroidism is surgical removal of the

offending parathyroid gland(s). However,there is evidence that when thehypercalcemia is mild, and the patient iscompletely asymptomatic, that manypatients can continue without any therapyand without any apparent ill effects, suchas renal calculi or bone demineralization.Many physicians will thus opt forwatchful expectancy in such patients.

However, when calcium levels areunduly high, therapeutic intervention isessential, and unless there is some specificcontraindication for surgery, then surgicalparathyroid exploration is the appropriatemode of treatment. However, even priorto surgery, if the calcium levels areextremely high, they can be brought undercontrol by hydration, by potent loopdiuretics such as Furosemide, and bybisphosphonates. Pamidronate is one of thenew generation of amino bisphosphonatesthat are extremely potent in bringing downserum calcium. Between 60 and 90 mg. ofPamidronate given as a single intravenousinfusion has been shown to normalizeserum calcium in 80 to 100% of patientsfor weeks or months.

If patients are unsuitable for surgery,or in those rare instances where surgeryhas been unsuccessful, the same mode oftreatment can be applied.

Where the parathyroid lesion has beenidentified by imaging techniques, it ispossible in some instances to inject abolus of alcohol directly into theparathyroid tumour, for the purpose ofablating it. This is not generally recom-mended, but has been employed in a fewinstances.

Other ancillary medications includeestrogen, which may reduce boneturnover. Since vitamin D deficiency mayaggravate skeletal disease, it should becorrected wherever detected.

Conclusion

HPT is a subtle disease process thatcan be responsible for severe derange-ments in health. It can be easily cured bya relatively simple undemanding surgicalprocedure requiring only a short stay inhospital. Patients with mild hyper-calcemia or who are unfit may be treatedmedically. Unnecessary delay or pro-crastination of definitive treatment mayresult in serious illness or fixedabnormalities that will not reversethemselves following an eventual

Hyperparathyroidism . . . con't from page 8 parathyroidectomy. As a rule, patientsprofit by definitive treatment of thiscondition by marked improvement ormaintenance of good health.

Irving B. Rosen, MD, FRCS(C), FACS,Professor of Surgery, University ofToronto; Department of Surgery, MountSinai Hospital; Co-Director Head andNeck Oncology Program, Mount SinaiHospital; Emeritus Consultant inSurgery, Princess Margaret Hospital,Ontario Cancer Institute; Director, Headand Neck Cancer Foundation.

Robert Volpé. MD, FRCP(C), MACP,FRCP (Edin. & Lon.), Professor EmeritusDepartment of Medicine, University ofToronto; Director (ret’d) EndocrineResearch Laboratory, Wellesley Hospital,Toronto; Founding President CanadianSociety of Endocrinology and Meta-bolism; Past President American ThyroidAssociation; recipient of many awardsincluding the Distinguished ScientistAward of the American ThyroidAssociation, and Gold Medal of the JapanEndocrine Society; Medical Adviser toThyroid Foundation of Canada.

thyrobulletin is publishedfour times a year: the first

week of May (Spring),August (Summer),

November (Autumn) andFebruary (Winter).

Deadline forcontributions for next

issue (Winter):

December 15, 2000

Contributions to:Ed Antosz, Editor973 Chilver Road,

Windsor, ON N8Y 2K6

Fax:(519) 971-3694

E-mail:[email protected]


Three steps control the way your thyroid glandfunctions.

FIRST, hormone released from your hypothalamus travelsto your pituitary gland (see diagram). This hormone signalsthe pituitary gland to release another hormone, ThyroidStimulating Hormone (TSH).

SECOND, TSH travels from your pituitary gland to yourthyroid gland. TSH triggers your thyroid gland to make thehormones thyroxine (T4) and triiodothyronine (T3).

THIRD, thyroid hormones T4 and T3 are released fromyour thyroid gland into your bloodstream. T4 and T3 travelthroughout your body and regulate the rate at which manydifferent organ systems work.

Hypothyroidism results when your thyroid gland isunderactive – it does not produce enough thyroid hormonesfor your body to function at the right level. Some of thesymptoms of hypothyroidism include fatigue, weight gain andintolerance to cold. Treating hypothyroidism is simple.Medication can replace the thyroid hormones your body ismissing.

The importance of your thyroid glandYour thyroid gland may only weigh an ounce, but this tiny

butterfly-shaped gland located on either side of your windpipehas a huge effect on your health. This gland produces andsecretes thyroid hormones which have a profound influenceon every organ system in the body — from the rate at whichyour heart beats to the speed at which you burn calories.Thyroid hormones regulate digestion, heart rate, bodytemperature, sweat glands, nervous and reproductive systemsand body weight. Hypothyroidism results when your thyroidgland does not produce enough hormones to meet your body’sneeds (underactive thyroid gland).

How common is hypothyroidism?Hypothyroidism is one of he most common and easiest

medical condition to treat. It is estimated that 700,000 to onemillion Canadians have an underactive thyroid gland. Thedisease affects men and women and is more common in peopleover the age of 40.

The thyroid gland – how yourthyroid gland works

Signs and symptoms of hypothyroidism• tiredness • coldness• weight gain • dry hair• chronic fatigue • lethargy• slow thinking • depression• brittle nails • thinning hair• hoarse deep voice • nervousness

Left untreated, hypothyroidism symptoms will becomemore noticeable and severe. An enlargement of the thyroidgland in your neck may develop (thyroid goitre). You maybecome forgetful and your thought processes may slow down.Over time, cardiovascular symptoms and elevated cholesterollevels may develop.

Getting back to normal: your treatmentTreatment for an underactive thyroid gland is

straightforward with the prescription medication levothyroxinesodium. Levothyroxine sodium, the generic name of themedication used to treat hypothyroidism, is one of the mostcommonly dispensed prescription drugs in Canada. Themedication is safe with virtually no side effects when patientsare on the correct dose. Levothyroxine sodium comes in arange of doses to meet the needs of each patient. Differentbrands of the medication are manufactured by differentcompanies.

What is the right dose for me?It is essential to determine the correct dose so that you are

not overtreated or undertreated. Your doctor will conduct teststo determine the most appropriate dose for you. After youhave been on the medication for four to eight weeks, yourphysician may retest your blood levels to confirm that youare on the right dose.

When will I feel better?Within a few weeks of beginning therapy, your symptoms

should begin to subside. You may begin to notice a differencein how you feel...you may experience an increase in energy.Over time, your dose may continue to be adjusted by yourphysician until you are on the most appropriate strength ofthe medication.

Things to remember• Don’t stop taking your pills because you feel better - if you

do, your symptoms may gradually return.• Forget to take a pill? Don’t worry. Simply take your next

pill as normal.• Don’t change from one brand of levothyroxine to another

without first discussing the change with your doctor. Thereare difference between brands manufactured by differentcompanies.

• If you do change, your doctor may repeat your blood testto make sure that you are receiving the same dose ofmedication.

Talk to your doctor if any of the following apply• You are allergic to any foods or medicines• You are pregnant or intend to become pregnant• You are breast-feeding• You are taking any other prescription medications


Research Report of Natalie Kotowycz

I am one of the students who wasfortunate enough to receive asummer research scholarship from

the Thyroid Foundation of Canada. Thisscholarship gave me the wonderfulopportunity of spending my summerworking on a thyroid research project atSunnybrook and Women’s CollegeHealth Sciences Center in Toronto. Aspart of the scholarship I was asked towrite a summary about my summer workfor publication in thyrobulletin.

I would like to thank the ThyroidFoundation of Canada for giving me thewonderful opportunity of spending mysummer working on a thyroid researchproject. I have recently completed a 12week studentship at Toronto’sSunnybrook and Women’s CollegeHealth Sciences Center where I wasinvolved with a study that is beingconducted by Dr. Silverberg and Dr.Levitt. The objective of our study is toevaluate the most effective treatment forhypothyroidism, a condition that occurswhen the body fails to produce adequatelevels of thyroid hormones. Since thyroidhormones play a pivotal role in manybodily functions including growth, energymetabolism as well as mood regulation,a deficit results in a wide array ofsymptoms. The characteristic features ofhypothyroidism consist of coldintolerance, weight gain, depression andfatigue.

A “healthy” thyroid gland producestwo hormones, of which 80% is T4(thyroxine or tetraiodothyronine) and theother 20% is the active hormone calledT3 (triiodothyronine). Customarily thetreatment for hypothyroidism has beensupplementation with T4 alone (i.e.Synthroid or Eltroxin). It has generallybeen believed that treatment with T4alone is adequate as 70-90% of the body’sT3 is derived from the monodeiodination(a specific type of conversion) of T4.However, it has recently been shown thatnot all symptoms of hypothyroidism arecompletely alleviated with T4 treatment.Patients treated with T4 may have normalthyroid blood test results and yet somecontinue to exhibit the classichypothyroid symptoms. It was thepersistence of these symptoms that led tothe suggestion that perhaps patientsshould be treated with both T4 and T3.The purpose of our study is to comparethe effectiveness of T4 treatment aloneto two different combinations of T4 withT3 by analyzing data from biochemicaltests, and physical exams along withvarious cognitive tests that look atmemory recall and attention.

I spent most of the summer recruitingand screening potential subjects for thestudy. This included analyzing blood

work and interviewing patients. I alsoassisted with the cognitive testing and hadan opportunity to sit in for some of thephysical exams as well as the physicianassessments. This study will yield verysignificant results – results that mayimprove the overall health status ofmillions of people. By comparing andmonitoring changes in the three differenttreatment groups, the study will helpdetermine whether there is a more suitabletreatment for people suffering the long-term effects of hypothyroidism.

I sincerely thank the ThyroidFoundation for providing me with thisenriching experience and for theirassistance and support with the study. Notonly did it serve as a wonderful steppingstone towards my future goal of becomingan endocrinologist but the study may alsoimprove the health and well being of themany people that, like myself, areafflicted with hypothyroidism.

If you are interested in participating inour study and are between 20-70 yearsold, have had a blood test in the past thatproved you have low thyroid activity, livein the Greater Toronto area and have beentaking Synthroid or Eltroxin for at least 2months, please call the study line at (416)480-4444.

Natalie Kotowycz

Left to right: Dr. Jay Silverberg, Eleanor King (Research Coordinator) and Dr. Anthony Levitt


he British Thyroid Foundation(BTF) contacted the BritishNutrition Foundation (BNF)

last December (1999) to ask if anyonewould be interested in writing articlesabout nutrition for BTF News. I acceptedthe invitation on behalf of the nutritionscientists at BNF. I was very interestedto read the articles in the BTF News lastyear written by Dr. Kreitzman and thesubsequent correspondence. Since thisarea is a particular interest of mine, Ithought I would carry on with this themeas my contribution.

Energy intake =energy expenditure +change in body stores

The equation above is a variation ofone of the basic laws of thermodynamics.You may think it rather odd to include itin an article in the BTF News. However,the energy balance equation just restatesthe fundamental fact that energy cannotbe made or destroyed, only convertedfrom one form to another. This is just astrue for energy used by humans (i.e. fromfood) as it is for power stations whichconvert energy in solid fuel or nuclearreactions into electricity and then heat,light and sound, and for the energy inpetrol which powers our cars.

The simple fact is that if we eat moreenergy than we use up, that extra energyhas to go somewhere (stored in ourbodies, mainly as fat). If we use up moreenergy than we eat, the extra energy hasto come from somewhere (from ourbody’s stores, mainly as fat). In hisarticles, Dr. Kreitzman outlined the waysin which our bodies use energy, wentthrough some of the mathematics to

Final word about dietingby

Dr. Gail Goldberg

explain where the figures behind rates ofloss come from, and dispelled some ofthe myths about dieting.

He also discussed some of theproblems about knowing exactly howmuch energy is in the food we eat. Hefocussed on the energy in and body storesparts of the energy balance equation. Heexplained very clearly how even smallchanges in energy intake can affectchanges in body stores – the amount andrate of the weight (fat) that is lost bysomeone when they go on a diet. Thecalculations of weight loss, and thechanges in metabolic rate were based onenergy intake. In this article I want tocomplete the picture by looking a bit moreat how energy expenditure affects energybalance.

Even if a dieter eats the same amountof energy every day, this will notnecessarily predict how much weight theywill lose. We also have to consider howmuch energy they are using up. In reallife, just as with our food intake, we canvary enormously from day-to-day in howmuch energy we use up. Just think of howyou, your friends and family spend atypical month. Think about the differentdays of the week, activities during theday, whether at work (and depending onthe sort of job), at home, or out and about;different activities in the eveningdepending on family circumstances,hobbies etc; different again at weekendsand on holiday.

As Dr. Kreitzman explained BasalMetabolic Rate (BMR) and RestingMetabolic Rate (RMR) depend mainly on

body weight (also on sex and age, but wecan’t alter that!). The amount of energywe expend on processing and digestingfood is about 10% of energy content ofthat food. So if someone is eating 1500calories per day, they will be using upabout 150 calories on ‘diet inducedthermogenesis’. That leaves energyexpended on physical activity as thecomponent of energy expenditure that wecan change.

So how can those who need to loseweight widen the gap between energy inand energy out? There are three ways:by reducing energy intake (i.e. dietingonly); by increasing energy expended onphysical activity (by exercise and otheractivities); by a combination of the two.It is really only in strictly controlledmetabolic studies that both energy intakeand energy expenditure can be veryprecisely controlled and measured.Because the energy used on physicalactivity is so variable, it helps to explainwhy apparently identical people, even ifsticking religiously to a diet, lose weightat different rates.

It also, of course, helps to explain whyit appears that some people can eat whatthey like and never gain weight whileothers can’t. We don’t necessarily seeeverything they eat and we may not beaware of everything they do. What seemslike too much for us may be just right forthem to keep them in energy balance andtheir weight stable.

One way of expressing total energyexpenditure to give an indication ofphysical activity is to express everythingas a multiple of BMR - a physical activitylevel (PAL). That way differencesbetween people due to weight, height, sexand age can be accounted for. PAL valuesreflect the amount of activity that people

con't page 13

T

New Mailing address:Thyroid Foundation of CanadaLa Fondation canadienne de la ThyroïdePO BOX/CP 1919 STN MAINKINGSTON ON K7L 5J7

New Website address:www.thyroid.caThe previous website willcontinue to be operational forsome time.

Pleasenote!


carry out – depending on their jobs,leisure activities, and other aspects oftheir lifestyle and behaviour. Valuesallow us to compare different groups ofpeople, or the same people under differentcircumstances. Recent analyses of verylarge data-sets have shown that sedentarypeople have PALs of about 1.4-1.5. Incontrast, moderately active people havePALs of about 1.6-1.8. The rare peoplewho are habitually very active use about2xBMR. You can estimate roughly howmuch energy you use by calculating yourpredicted BMR using the equations in Dr.Kreitzman’s article. Then multiple this byan appropriate factor depending onwhether you regard yourself as sedentary,moderately active or very active. Toillustrate the real extremes of thesemeasurements, PALs in bed-boundpeople are about 1.2 while the highestPALs ever measured were 4.5-4.7. Thesemeasurements were made in Tour deFrance cyclists (while they were actuallycompeting), and in Dr. Mike Stroud andSir Ranulph Fiennes when they walkedacross the Antarctic. Their energyexpenditure averaged more than 8000calories per day for weeks. They couldnot possibly eat or carry enough food tomeet those needs. It’s no wonder they lostso much weight – virtually all their bodyfat and a considerable amount of leantissue too.

Finally, what about the ever-increasingproblem of overweight and obesity? Inthe UK, throughout Europe, the USA andeven in developing countries, obesity isa growing and a serious public healthproblem. The number of people classifiedas overweight or obese in the UK hasmore than doubled in the last 15 years.The most recent data shows that morethan 40% of men and women areoverweight, while 20% are obese. Whyis this? Relatively few people have aproblem with their metabolism. Theproblem does not lie in our genes either.They cannot have altered so radically inless than a generation. Is it what we eat,can the problem be blamed on too manyhighly palatable foods which contain lotsof fat and carbohydrate? Partly, yes,although the actual percentage of fat andcarbohydrate in our diets has been prettyconstant for some time. Furthermore,trend data from dietary surveys show weare actually eating less energy thanpreviously. What does this mean? Well,

Final word about dieting . . con't from page 12 if the population is getting heavier andfatter, despite eating less energy, then theamount of energy used up on physicalactivity must be declining even faster.Think of all the labour-saving devices wehave at home and at work; remotecontrols, mobile and cordless phones,how much we use our cars, even for veryshort journeys, how often we useelevators and escalators rather than thestairs, and how much time we spendsitting watching TV, videos, and workingor playing with computers!

All the big studies and surveys havenow come to the conclusion that physicalactivity, or more correctly, inactivity,plays a very large part in the developmentof overweight and obesity. It also playsan important part in weight loss, and inthe maintenance of weight.

As a species, humans are very good atrecognizing excesses. This makes sensefrom an evolutionary and biological pointof view, but when faced with conditionsof plenty, we struggle against thatbiology. The myriad of factors that affectand regulate appetite, and the interactionsbetween food intake, energy, expenditure,and body composition, are currentlykeeping many physiologists, nutritionists,and clinicians very busy, but that’sanother story.

Dr. Gail Goldberg is a SeniorNutritionist at the British NutritionFoundation (BNF). Prior to joining theBNF in 1999 she was at the MedicalResearch Council’s Dunn Nutrition Unitin Cambridge, UK, for more than 16years.

Reprinted with permission from BTFNews, publication of The British ThyroidFoundation.

If you have not made your will yet, willyou do it now? Will you remember the

Thyroid Foundation of Canada?

If you plan to update your will, will youdo it now? Will you help the Thyroid

Foundation of Canada?

If we have helped you, will you help ushelp others? A bequest, an insurance

policy, a tax exempt donation – will youthink about it? Will you do it now?

Tribute to TFC’swebsite and its

coordinator,Ellen Garfield

August 16, 2000

I just spent some time reviewingvarious articles on your website, andI am amazed and happy at theinformation and quality that youprovide.

I developed thyroiditis about threeyears ago, due to subacute viralinfection, and I have been astoundedat the impact that becominghypothyroid has made on my life (Iam also a pharmacist). I went from avery active person to, let’s say, a lessactive overweight person. I am stillstruggling with the weight issue. Theseveral months after being diagnosedwith hypothyroidism were verydifficult. I was seeing an endocrin-ologist and getting tested and dosageschecked – but no one did tell me whatan impact it would have on my life.

The information you have on yourwebsite is helping me now to sortsome things out and I am going tomy family physician with some ofthat information.

Once again truly grateful inWindsor.

Marika Gaspic Piskovic


Chapter news

EdmontonThe Edmonton chapter has presented

three information programs at theNorthgate Lions Senior Centre, inFebruary, June and October. We showedthe videos, Hypothyroidism andHyperthyroidism and “The WomanBehind the Foundation”, withdiscussion afterwards. These presenta-tions were very well received. We lookforward to increased chapter activity.

KingstonChristmas tree ornaments are once

again being sold by Kingston chapter,coordinated by Phyllis Mackey. The boxof 3 Year 2000 Spun Glass OrnamentGift Set sells for $11.50 ($10 plus $1.50tax), making a profit of $5 for thechapter from each box sold. Theornaments consist of a deer, a Santa, anda wreath with 2000 in 22 karat gold.These delightful gifts can be purchasedat the chapter office, every Wednesdayor telephone for an appointment: 613-389-3691.

Kingston chapter hopes to double itsfund-raising capacity as it now has twomonthly dates for sponsoring bingo.

Please save your A & P GardinerCentre grocery store tapes for thechapter’s “A & P Save-A-Tape Program”.We receive $1 for every $450 of tapes.Elizabeth Mitton totals the tapes andpackages them into bundles of $1000. Sheis always looking for more tapes to swellour total.

The Pablo Paddlers , a team in thesecond annual Dragon Boat races heldSeptember 9 was again sponsored byKingston chapter. We thank HeidiLangen, organizer of the Pablo Paddlerscrew, and all her hardworking paddlersfor this joint community effort. Thechapter receives publicity and money israised for Hospice Kingston.

MontrealThe board members met several times

during the summer. We answeredquestions from people who received theresults of the blood tests done at the June9 TAQ clinic.

Bob Black retired from the board thispast year. I want to express our thanksfor all the work he put into the Montrealchapter. We wish Bob and his wife, Sally,good luck in their future endeavours.

Saint JohnWe urgently need volunteers! We

need YOU. We will show you what todo and when to do it.

If you have a few hours or a fewminutes four times a year: we need 1volunteer to contact speakers foreducation meetings; 1 volunteer tocontact the media on our behalf. Andwe need 1 or 2 volunteers to contactmembers by mail, e-mail or phone.

If you have a few hours each week:we need 1 or more volunteers to returncalls from our Help-Line (if we havemore than 1 volunteer, we can rotateturns).

If you have a few hours now andthen: we need 4 volunteers to distributeeducational materials and brochures topharmacies, doctors’ offices, libraries,hospitals.

Help us keep your chapter alive!!Call Irene 506-696-2247 and leave amessage. I await your call.

* * * * *

Nous avons un besoin pressant debénévoles! Nous vous montrerons quoifaire et quand le faire.

Avez-vous quelques heures ouquelques minutes – 4 fois l’an? Nousavons besoin de 1 bénévole pourcontacter les conférenciers pour lesréunions éducatives; 1 bénévole pouravertir les média de nos réunions; 1 ou2 bénévoles pour contacter nosmembres par poste, courriel ortéléphone.

Avez-vous quelques heures chaquesemaine: nous avons besoin de: 1 (ouplus) bénévoles pour retourner lesappels téléphoniques à notre ligne-soutien (le plus de bénévoles, le moinsde temps et de travail).

Avez-vous quelques heures de tempsen temps: nous avons besoin de 4bénévoles pour distribuer nos dépliantset nos matériaux éducatifs auxpharmacies, bureaux de médecins,bibliothèques et hôpitaux.

Aidez-nous à préserver notresection!! Appelez-moi, Irène, au 506-696-2247 et laissez le message – je vousattend!

TAQ June 9, 2000 in Montreal. Left to right: Donna Cruckshank,Marvin Goodman and Corine Schiller


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Health, the Foundation of all HappinessThe National Board and Staff

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BRITISH COLUMBIA/COLOMBIE-BRITANNIQUECowichan Victoria Oldnall (250) 246-4021Vancouver Jacquie Huntington (604) 266-0700Victoria Lilias Wilson* (250) 592-1848

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QUEBEC/QUÉBECMontréal Sharon Goodman (514) 482-5266

NEW BRUNSWICK/NOUVEAU BRUNSWICKMoncton Bob Comeau (506) 855-7462Saint John Irene Britton (506) 633-5920

NOVA SCOTIA/NOUVELLE ÉCOSSEHalifax Phyllis Payzant (902) 477-6606

Chapter & Area Contacts/Liaisons pour les sections et districts

Staff/équipe Katherine Keen, National Office Coordinator/Coordinatrice du bureau nationalHelen Smith, Membership Services Coordinator/Coordinateur des services aux membres

Office Hours/ Tues.- Fri., 9:00 am - 12:00 pm/1:00 pm - 4:30 pm • Mardi à vendredi, 9h00 à 12h00/13h00 à 16h30Heures du bureau

Tel: (613) 544-8364 / (800) 267-8822 • Fax: (613) 544-9731 • Website: www.thyroid.ca

National Office/Bureau national

PRINCE EDWARD ISLAND/ÎLE-DU-PRINCE ÉDOUARDCharlottetown Nancy Sellick (902) 566-1259

NEWFOUNDLAND/TERRE NEUVEAvalon/St. John’s Dorothy Barrett (709) 726-9181

Gander Marilyn Anthony (709) 256-7687Marystown Shirley Penny (709) 279-2499

ONTARIOBurlington/Hamilton Arlene Simpson (905) 637-8387

Kingston Margaret Burdsall (613) 389-3691

Kitchener/Waterloo Cassandra Howarth (519) 884-6423

London Barbara Cobbe (519) 649-5478

Ottawa Nora Hockin (613) 729-9089

Petawawa/Pembroke Liz Moss (613) 732-1416

Sudbury Lois Lawrence (705) 983-2982Thunder Bay Darlene Ibey (807) 625-1419Toronto Margaret Hunter (416) 398-6184

* Area Contact/Contact régionaux

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