I HAVE been covering the subject of fatigue and of feeling tired at the time (TATT) in recent columns.

I have tried to look at a couple of the more unusual causes but they have by no means been exhaustive (pun intended!) and the subjects could have included heart problems, anaemia, respiratory conditions and many more besides.

If you have any requests of subjects you would like me to cover, please contact me as usual. This week we are concluding with hyperthyroidism.

When the thyroid gland produces too much thyroxine, the patients are said to have hyperthyroidism.

The symptoms are sometimes easy to miss as they can be mimicked by drinking too much coffee and not eating healthily.

Sound familiar? I personally develop mild forms of several of the main symptoms of hyperthyroidism if I drink a large cup of fresh coffee!

The common symptoms are rapid heart beat, sweating, and tremor.

Patients also become heat intolerant, experience weight loss and anxiety, women can also develop irregular periods and may develop a swelling in the neck known as a goitre.

There are many causes of hyperthyroidism and blood tests and scans assist in discovering the cause.

One of the most common causes is an autoimmune condition called Grave's disease. An autoimmune disease is one that is caused by the body's immune system attacking its own tissues because it incorrectly recognises its own cells as invaders.

Grave's disease is a condition where the immune system produces an antibody that interacts with the cells of the thyroid and stimulates them to secrete excessive amounts of thyroid hormones. People who have one autoimmune disease may be at a higher risk of developing another. There are links between Grave's disease and insulin dependant diabetes.

There are also links with the condition called pernicious anaemia, so these patients are well monitored for the signs and symptoms of other connected conditions.

There are some genetic links for Grave's disease, which is also called thyrotoxicosis, so it can be seen to run in families.

Thyrotoxicosis mainly affects women between 30 and 50 years old.

As well as experiencing the symptoms stated above, there is an easily recognisable sign of the disease, although not every patient will develop it.

The eyes can become bulging due to swelling of a fat pad behind the eye.

Due to the retraction of the eyelids, the delicate conjunctiva can become swollen and inflamed sometimes resulting in double vision.

So what can be done to help this condition? Medication is used to reduce and control the symptoms both short and long term.

Sometimes a surgical approach is adopted to remove part of the thyroid gland.

Another form of treatment called radioactive iodine treatment or RAI is also an option for some patients.

Recent attempts to find the right dose of RAI to afford a cure for the over activity, without causing underactivity of the thyroid as a side effect have proven difficult.

Up to 20per cent of patients who have RAI will develop hypothyroidism within the first couple of years of treatment. Those patients affected may have to take life long supplements of thyroid hormones.

Several readers have requested more actual cases, so I will head in that direction next time. As always, if you have any special requests or specific subjects you would like covered, please contact me on ilkleychiro@tiscali.co.uk or at Ilkley Chiropractic Clinic on 605060.