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THYROID DISEASE AND CORONAVIRUS

THYROID DISEASE AND CORONAVIRUS

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It is very understandable that during this period of global fear and panic most thyroid patients would be extra worried about their health with regards to their chances of contracting the coronavirus, managing both an infection and their thyroid disease, and the risk involved in attending hospitals  and taking thyroid medications. These concerns came about due to the information that people with some underlying health conditions will be at higher risk of contracting the virus and experience difficulties in managing their infection. The thyroid Ghana Foundation has compiled information to help patients during this pandemic by addressing some frequent questions that have been raised by our members on the coronavirus outbreak and thyroid disease.

Here are some questions, answers and guidelines to help thyroid patients stay safe during this pandemic.

Are individuals with autoimmune thyroid disease at risk of COVID-19 infection?

COVID -19 is a new virus, so there is currently no information on how it affects individuals with thyroid disease.  However thyroid disease is not known to be associated with increased risk of viral infections in general, nor is there an association between thyroid disease and severity of the viral infection. We know there have been several tests and observations that have been made after the outbreak of the virus and yet none have isolated thyroid patients as a group of interest. This could be due to the fact that an autoimmune thyroid disease does not make one immunocompromised. The part of the immune system that’s responsible for autoimmune thyroid conditions is separate to the immune system that’s responsible for fighting off viral infections, such as COVID-19.  Patients who are classified as having a weakened immune system (immunocompromised) are typically those with conditions such as leukaemias, HIV and AIDS, or who are on medicines such as high-dose steroids, immunomodulatory drugs for rheumatoid arthritis or multiple sclerosis, cancer chemotherapy or following organ transplantation.

Does medication for my thyroid disorder suppress my immune system?

Neither levothyroxine, nor carbimazole nor propylthiouracil, are immunomodulatory therapies. i.e. they do not change nor weaken your immune system. However, some patients with thyroid eye disease will be on high doses of steroid medication which can suppress the immune system

What happens if I am on steroid medication for my thyroid eye disease?

Discuss your treatment with your doctor. Depending on your medication, dosage or severity of your condition it may be necessary to suspend treatment for your thyroid eye disease until the pandemic is over.

Are patients who have had radioiodine therapy or thyroid surgery at higher risk of COVID-19 infection?

There is no evidence to show that radioiodine therapy or thyroid surgery for benign (non-cancerous) thyroid disease would put a patient at higher risk of COVID-19 infection. However, rules for staying safe during this period must be strictly adhered to both prior  and post thyroidectomy. It would be very difficult for a patient to manage a COVID-19 infection while recovering from thyroid surgery, especially if the infection brings symptoms such as cough. This may affect the healing process and cause the patient a great deal of pain. Patients who are scheduled for thyroidectomy who contract COVID-19 may be prevented from undergoing the procedure since they may not get clearance from the cardiovascular unit.

In some countries with high COVID-19 infections, hospitals have been instructed to postpone all non-urgent surgery during the outbreak to focus resources on fighting the pandemic and to prevent new infections by those visiting the hospitals for unrelated illnesses. But that is not the case in Ghana now. The Surgical department of the Korle-Bu teaching hospital will carry out scheduled thyroid surgeries till otherwise instructed by the Ministry of Health. However, patients in recovery would be required to adhere strictly to the guidelines for preventing corona virus infection as for the reasons stated above.

Is it safe to visit the endocrine clinic during this pandemic?

Visiting the hospital may not be too safe for now.  However, the Endocrine clinic at the Korle-Bu teaching hospital has put in the necessary infection control measures to ensure staff and patient safety during this COVID-19 period. The Clinic still runs on Tuesday mornings with the added option for telephone consultations for patients who are unable to visit the premises. If you are feeling well, then please don’t contact your endocrinologist as they may be busy attending to COVID-19 patients. However, if you are feeling very unwell even prior to a scheduled visit, then please do not hesitate to call the clinic  for advice. Please make sure you have all you need, blood tests, etc. before your hospital visit to avoid multiple trips to the clinic on the same issue. Patients who attend their clinics elsewhere should call the hospital to find out if there are special arrangements for the period. Also ensure that you always wear face masks when visiting the hospital.

Is it safe for thyroid patients to wear face masks?

There are different types of face masks. (medical and non-medical). The medical type are designed to be worn by health care professionals who are at a greater risk of exposure to the virus and are to be worn for a specific period. These are different from the non-medical ones which the general public are encouraged and expected to wear which are not associated with oxygen/ hypoxia problems.

Face masks (non medical) are generally safe for thyroid patients and would be effective in preventing spread of infection from wearers to others and vice versa. Please ensure you were them appropriately in public areas and also avoid touching them.

Safety Guidelines for Thyroid Patients

Thyroid patients should adhere to all the rules for staying safe during this period.  However, patients especially those who experience shortness of breath must regulate the wearing of face masks.

In addition, all thyroid patients must:

  • Ensure they take their medication and manage their condition properly.
  • Ensure they do not run out of medication which could lead to trips to the drug store especially during a lockdown.
  • Only take your thyroid tests at standardized laboratories which adhere to COVID-19 safety guidelines.
  • Ensure you visit the clinics on time for your appointments and carry along all your required lab results.
  • Take medications exactly as prescribed.
  • If experiencing symptoms such as fever, cough, shortness of breath, kindly contact the COVID-19 hotline and the endocrine clinic.
  • Kindly disclose your thyroid condition when speaking with the COVID-19 response team

References

Excerpts of articles from:

British Thyroid Foundation

Thyroid Foundation of Canada

Hospital for Special Care

Reviewed by:

                                                       Dr. Mrs. Josephine Akpalu

                                                       (Head, Endocrine Unit, KBTH)

staffTHYROID DISEASE AND CORONAVIRUS
Message From The Federal President | Covid-19

Message From The Federal President | Covid-19

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In this tough and unprecedented time, there is vast amounts of information circulating about COVID-19, which may be overwhelming and confusing.  Some thyroid patients have questions on how does this impact them. There is no evidence that patients with thyroid issues have something more to worry as compared to the rest of the population. What each one of us can do is take proper recommended measures that are advocated by the WHO and Health Authorities in each of your countries. Maintaining safe distance (i.e. Social distancing), wearing face-mask, hygienic lifestyle i.e. thoroughly washing hands will minimize the chances of exposure. Best is not to take any chances of socializing outside your house. When going out for groceries please take all the precautions and keep a safe distance from others. Also being honest with yourself when and if you think there are symptoms to isolate yourself from others will be a key to containing the spread of the virus.

We also want thank and salute the amazing healthcare and medical providers who have been working tirelessly in response to this pandemic – we appreciate your efforts to keep the people of your countries safe during this pandemic.

Governments the world over have taken measures to stop the spread of COVID-19 by temporarily closing down places and traffic where people could come in contact with each other. Please strictly adhere to the advice on ‘social distancing’, its better to NOT take any chances. Scientific communities are still discovering more about the virus each day.

You will find the following guidance most commonly seen on professional websites, please do follow this guidance:

  • Avoid close contact with people and strangers not known to you.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • It is especially important to clean hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.
  • Avoid traveling if you are sick and also avoid crowded places.

We understand this is a tough time for people all over the world, including our thyroid community. To ensure you have access to the right information, we have provided a few sites below, for your reference.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

Please ensure you follow the guidance of your federal and state governments and health authorities to help contain the spread of the virus. Be sure to follow appropriate hygiene precautions and social distancing, while observing advice about self-isolation and quarantining, should you come into contact with someone who has tested positive for COVID-19.

Please keep and stay safe in these difficult times.

Ashok Bhaseen, M.Pharm, MMS
President Thyroid Federation International

staffMessage From The Federal President | Covid-19
Thyroid Ghana Foundation Holds Maiden Patients Forum

Thyroid Ghana Foundation Holds Maiden Patients Forum

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The Thyroid Patients Forum is a Thyroid Ghana Foundation initiative which aims to give thyroid patients an opportunity to interact with Consultants and Specialists from the College of Health Sciences and Korle-Bu Teaching Hospital who are involved in the diagnosis, management and treatment of thyroid cases.

 

The Founder and President of the Foundation, Mrs. Nana Adwoa Konadu Dsane, who had undergone surgery for a thyroid problem, chose to organize the maiden edition of the Thyroid Patients Forum on her birthday, 20th October, 2018 to share the special day with patients under the Foundation’s Patient Support Programme. On the importance of the forum, Mrs. Dsane explained that the foundation realized that there is very little information on thyroid disorders out there and this can cause a lot of panic among patients who already experience anxieties due to their condition and desperately need to know what steps to take to relieve the stress associated with the disease. She noted that patients who visit the clinics for treatment do not get enough opportunity to ask questions relating to their condition mainly because, the clinics are very busy and time allocated per patient is very limited. She added that it was necessary to host the forum not only in English but also some local languages to cater for a wide category of patients.

 

The Forum was chaired by Rev. Prof. Patrick F. Ayeh-Kumi, Provost of the College of Health Sciences, University of Ghana and Chairman of the Management Board of the Thyroid Ghana Foundation. He said at the beginning of the forum that the programme has to be very informal in order to encourage participants to ask questions especially those who may feel intimidated to do so. He proceeded throughout the programme to translate all discussions by the consultants in Ga and Akan for the benefit of the participants.

 

The event was also attended by Dr. Alfred Tetteh (aka Prof T), Consultant Surgeon at Department of Surgery. Among other things Prof T provided detailed explanations on what goes into thyroid surgery, what patients are required to do prior to the surgery and what to expect after. Dr. Mrs. Josephine Akpalu, Consultant Endocrinologist and Head of the Endocrine Unit, Department of Medicine, was also present to provide an overview of the thyroid gland and thyroid disease problems. She charged participants to test for thyroid disorders and advised on what steps to take if the test results are unfavorable.

 

Dr. Naa Adorkor Aryeetey is a Radiation Oncologist at the National Centre for Radiotherapy and Nuclear Medicine and she was at the event to talk about thyroid cancers and the use of radioactive iodine to treat hyperthyroidism (Overactive thyroid disorder). She used the platform to encourage the general public to seek earlier treatments for thyroid diseases as this can be crucial in preventing thyroid cancers. Mrs Beatrice Williams, Clinical Psychologist, Department of Psychiatry took the patients through a quick counseling session to give them the needed mental support and encourage them to stay strong throughout their treatment. She noted that being a thyroid patient can be very disheartening due to the fact that the condition may require lifelong treatment. She added that patients in many cases can easily become depressed which is also a major health problem and can be very expensive to treat. She therefore encouraged patients to always concentrate on the positive side of life and to try as much as possible to avoid stressful situations. Her session was very interactive and the effect she had on the patients was almost instant.

 

Ms. Portia Dzivenu is a Dietician and Snr Research Assistant at the Department of Nutrition and Dietetics, School of Biomedical and Allied Health Sciences. She gave a breakdown of foods that are healthy for both categories of thyroid disorders that is hypo and hyperthyroidism. She was on call to provide answers to all the patients’ dietary concerns. The forum was hosted by Ms. Janet Boateng, Host and Producer of “Campus 360 Live”.

 

During the programme Participants were given information sheets which covers all aspects of thyroid disorders and treatments. The programme ended with a celebration of the Founder’s birthday. She used the platform to encourage all participants to be ambassadors for thyroid health and also provided information on future projects under the Foundation’s Patient Support programme.

 

The Thyroid Patients Forum was proudly supported by Ernest Chemist, Kenzo’s Place, Bedita Pharmacy Ltd, The College of Health Sciences, University of Ghana, Chartered Institute of Leadership and Governance, Departments of Medicine and Therapeutics and Surgery of the College of Health Sciences, the Dsane, Kumahlor, Pinkran and Burah Families, Art TwoThings Media, Volunteers of the Thyroid Ghana Foundation and Mensdo Bissap Beverages.

staffThyroid Ghana Foundation Holds Maiden Patients Forum
How I battled cancer – Jeremie Van-Garshong reveals

How I battled cancer – Jeremie Van-Garshong reveals

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Radio and television presenter, Jeremie Van-Garshong cannot stop thanking God for healing her of the thyroid cancer she has been battling for the past 10 years. The Live FM presenter who has been off air for the past two months admitted that getting thyroid cancer has been the toughest challenge she ever had to face and fight for a very long time.

“But God used my toughest challenge to bring me my biggest testimony ever and I can’t wait to tell it all” she said as she narrated her ordeal to Showbiz in an interview on Friday, October 14.

Jeremie revealed that it was only her family and close friends who knew her struggle with cancer and how hard it was for her to pretend as if there was nothing wrong with her as she went about doing her duties as a radio and television presenter.

According to her, her biggest fear was when doctors told her she could lose her voice in an operation in Germany last two months because the surgery involved removing a tumor in her throat.

“I lost hope because that was my career hanging on the line but as the doctors wheeled me into the theatre, I remember feeling a hand gently take my hand and walk alongside my bed.

“And as the two nurses began plugging machines and tubes into my body, I started praying saying ‘Jesus stay with me and in my heart’. I knew it was His hands that held mine.”

She continued saying “After the surgery, my voice went for weeks and that got me scared because I thought I wouldn’t be able to speak again and that was the end of my career. But thanks to God, I started speaking again and completely healed in the name of the Lord.”

To her, the two months she was away in Germany has really brought her closer to God because she has come to accept that it is only God who can heal and not man.

Initially, she did not want the story out but now Jeremie wants the whole world to know about her experience because she believes there is a true God who is always there for His children in times of need.

The outspoken presenter said she is done with a song she composed during her trying moments because it is not everyone who gets lucky with such surgeries.

“I am yet to give it a title. It will be out very soon and I am very sure it will change the lives of many who might be going through similar challenges”, she added.

The Touchdown presenter has also written a book titled Valley of the Shadow Of Death” explaining into details the struggles she went through battling with thyroid cancer and how she was finally saved by God.

staffHow I battled cancer – Jeremie Van-Garshong reveals
Thyroid Disorders in Central Ghana: The Influence of 20 Years of Iodization.

Thyroid Disorders in Central Ghana: The Influence of 20 Years of Iodization.

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Abstract

BACKGROUND:

Ghana began mandatory iodization of salt in 1996. This study compares the prevalence of thyroid disorders before and after the introduction of iodization.

METHODS:

This is a retrospective study of thyroid cases from the middle belt of Ghana between 1982 and 2014. To demonstrate a link between iodization and hyperthyroidism and autoimmunity, we compared the prevalence of hyperthyroidism and autoimmune thyroid disorders before and after the iodization programme.

RESULTS:

A total of 10,484 (7548 females, 2936 males) cases were recorded. The rate of thyroid cases seen was 343/100,000. Nontoxic nodular goiters (25.7%) and toxic nodular goiters (22.5%) represented the second commonest thyroid disorders recorded. The prevalence of hyperthyroid disorders seen after 1996 was significantly higher than the prevalence seen before the iodization (40.0 versus 21.1%, p < 0.001). The prevalence of autoimmune disorders recorded after iodization was significantly higher than that before the iodization programme started (22.3% versus 9.6%, p < 0.001).

CONCLUSIONS:

This study has revealed a significant increase in thyroid admissions in Central Ghana over the decades. A connection between iodine fortification and iodine-induced hyperthyroidism and between iodine fortification and autoimmune thyroiditis has been shown in this study.

staffThyroid Disorders in Central Ghana: The Influence of 20 Years of Iodization.
Thyroid Disorders in Accra, Ghana: A Retrospective Histopathological Study at the Korle-Bu Teaching Hospital

Thyroid Disorders in Accra, Ghana: A Retrospective Histopathological Study at the Korle-Bu Teaching Hospital

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EM Der, SE Quayson, JN Clegg-Lamptey, EK Wiredu, RKD Ephraim, RK Gyasi

Abstract

There is a scarcity of data on thyroid disorders in Ghana. This retrospective study examined the spectrum and incidence of thyroid disorders by reviewing all thyroid disorders reported in the De-partment of Pathology, Korle-Bu Teaching Hospital (KBTH) between 2004 and 2010. Data was collected on the clinical and histological characteristics of all thyroid disorders reported during the study. 1300 (3.7%) cases were reported, representing an annual incidence of 185.7 cases. The ages ranged from 1-86 years with a mean of 41.5 (SD=13.9). Most [353 (27.4%)] of the cases were be-tween 30-39 years group. Majority, 1141(87.8%) were females. The top eight common thyroid dis-eases were; non-toxic multinodular goitre 1002(77.5%), follicular adenoma 86(6.6%), diffuse toxic goitre 42 (3.2%), papillary thyroid carcinoma 40(3.1%), thyroglossal duct cyst 35(2.7%), Hashimo-to’s thyroiditis 28(2.2%), lymphocytic thyroiditis 22(1.7%) and follicular carcinoma 17(1.3%). Sixty-six (43.4%) of the neoplastic thyroid disorders were malignant with a prevalence of 0.18 among thy-roid samples and annual incidence of 9.40 cases. The commonest thyroid cancer was papillary car-cinoma 40(60.6 %), with a mean age of 38.3 SD=16.1 years, majority, 34 (82.9%), were women. A wide spectrum of thyroid disorders exists in Ghana, with an annual incidence of 185.7 cases. The commonest malignant thyroid disorder was papillary carcinoma, though iodine deficiency is en-demic in Ghana and on this basis; one would have expected follicular carcinoma to be the com-monest thyroid cancer in Ghana.
staffThyroid Disorders in Accra, Ghana: A Retrospective Histopathological Study at the Korle-Bu Teaching Hospital