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Nurse Practitioner Column - Your Health PDF Print
Jun 02, 2014 at 08:23 PM

Winnipeg Free Press > Local > That constant chill could be thyroid-related


Winnipeg Free Press - PRINT EDITION

That constant chill could be thyroid-related

By: Donna Alden-Bugden



Posted: 05/30/2014 1:00 AM |

Have you been feeling cold lately?

Even when you are inside and everyone around you is perfectly warm?

If so, there is a possibility you are suffering from more than just a bout of the chills brought on by our unusually cool spring weather.

Constantly feeling chilly is one of the classic symptoms of a condition called hypothyroidism, a condition that affects the thyroid gland. This condition -- which affects about one in 10 Canadians, with as many as 50 per cent of those still undiagnosed -- is caused by a lack of hormone production in the thyroid, which is a small, butterfly-shaped gland at the base of the neck.

The thyroid's job is to secrete hormones essential to growth and metabolism, which is why hypothyroidism tends to get worse as we age.

When the thyroid fails to do what it is supposed to do, the body begins to exhibit a number of symptoms. In addition to feeling cold, symptoms of hypothyroidism include fatigue, lack of appetite, lack of concentration, vague aches and pains, dry skin, muscle cramps, excessive sleepiness, modest weight gain and depression.

It is important to note hypothyroidism should not be confused with hyperthyroidism, which occurs when the thyroid gland produces excess hormones, and can cause a person to feel overheated, shaky and lose weight. Symptoms of an overactive thyroid include intolerance of hot weather, excessive sweating, shakiness and muscle weakness.

As with many conditions, getting an early diagnosis of hypothyroidism is important. Left unchecked, it can lead to more severe health problems, including heart disease. Other health problems such as lupus, diabetes, arthritis and reproductive difficulties are associated with an under-functioning thyroid gland. Left untreated, hypothyroidism can worsen to where you have symptoms of mental illness, such as depression, confusion and psychoses.

There are four main causes of hypothyroidism:

-- Hashimoto's thyroiditis, an autoimmune disease that causes an inflammatory process of the thyroid gland;

-- Treatment of Graves' hyperthyroidism with radioactive iodine or by thyroid surgery;

-- Babies born without a thyroid gland or a poorly functioning one (congenital hypothyroidism);

-- Surgical removal of the thyroid gland, for example, as a treatment for thyroid cancer.

The diagnosis of hypothyroidism is made through a simple blood test which shows an increased level of thyroid-stimulating hormone coming from the pituitary gland, and a lower level of the T4 hormone.

People at risk of hypothyroidism include women over age 60, pregnant or post-partum women, people with Type 1 diabetes, a family history of hypothyroidism or an autoimmune disease.

Newborn babies are tested using a heel pad blood-spot test. Neonatal hypothyroidism is caused in most babies by the absence or underdevelopment of the thyroid gland. As thyroid hormones are essential for brain development and growth, if babies are left untreated, they can develop severe physical and mental defects.

Other diagnostic tests include looking for antibodies to the thyroid, thyroid ultrasound and CT or MRI if your health-care practitioner is worried about tumours.

Fortunately, once the condition is diagnosed, it is relatively easy to treat.

In most cases, doctors will prescribe a thyroid-hormone replacement in the form of a small pill, daily, for life.

The pills contain thyroxine -- known by drug names such as Levothyroxine -- which is a synthetic hormone with few impurities, very few side-effects, and almost no allergic reactions.

If you have any of the symptoms of hypothyroidism, you should consider speaking to your primary-care provider to see if you can get a TSH level done. Meanwhile, keep a journal of any symptoms you are having, to be ready to present to your primary-care provider.

Donna Alden-Bugden is a nurse practitioner with the Winnipeg Regional Health Authority's McGregor QuickCare Clinic.

Republished from the Winnipeg Free Press print edition May 30, 2014 A19


Last Updated ( Jun 02, 2014 at 08:51 PM )
The Nurse Practitioner in Quebec - Video PDF Print
Jan 31, 2012 at 01:30 PM
Last Updated ( Jan 31, 2012 at 01:33 PM )
MEDIA RELEASE -CNA Says 'It's About Time' PDF Print
Oct 17, 2011 at 09:02 PM




CNA’s new campaign says it’s about time Canadians consider nurse practitioners as the answer to more access to better health care.

Ottawa, October 17, 2011 – The Canadian Nurses Association (CNA) today launched a campaign to educate Canadians about how nurse practitioners can improve access to quality health care. Almost five million Canadians do not have a primary health-care provider and those that do often have a hard time accessing care. These two factors result in a heavily-burdened and overcrowded health-care system. More nurse practitioners will reduce wait times, improve access to more options and enhance the care of the whole patient.

            As Canadians, we’re proud of and grateful for this country’s health-care system, but it’s time to recognize we deserve even better,‖ says Judith Shamian, CNA’s president. ―Nurse practitioners have played a valuable and essential role in the system for many decades. Given the stress the health-care system is currently under, now is the time to realize just how much more value nurse practitioners can bring to Canadians’ health care.‖

                  Nurse practitioners are registered nurses who have additional education and nursing experience. Working collaboratively with other health-care providers, they provide quality care for patients, order tests, prescribe medications, and diagnose and manage chronic illnesses. They work in a wide variety of settings including community clinics, doctors’ offices, nursing homes, hospitals and in patients’ homes.

            In order for Canadians to feel confident in our country’s health-care system, they need to be certain they can easily access quality care whenever they need to,‖ says Rachel Bard, CNA’s chief executive officer. ―As nurses, we know our services can help make health care more accessible, and our commitment to educating patients and involving them in decisions related to their care helps them achieve the best possible health.

            CNA’s campaign aims to educate Canadians about how their access to health care can be improved, how they can have more options and what role nurse practitioners can play. The campaign will also encourage governments to invest in more nurse practitioners as an investment in better health. The Nurses Association of New Brunswick will help CNA launch its national efforts with a four-week campaign in Fredericton. The campaign — with the slogan, Nurse Practitioners: It’s About Time! — will then roll out in regions across the country.

            There are more than 3,000 nurse practitioners in Canada and every provincial and territorial government has nurse practitioner legislation in place. In 2010, there were 75 nurse practitioners in New Brunswick. That number is expected to rise in the near future with a commitment from the provincial government for 15 new nurse practitioner positions.

            For more information about CNA’s nurse practitioner campaign, please visit www.npnow.ca.

The Canadian Nurses Association (CNA) is the national professional voice of registered nurses in Canada. A federation of 11 provincial and territorial nursing associations and colleges representing 143,843 registered nurses, CNA advances the practice and profession of nursing to improve health outcomes and strengthen Canada’s publicly funded, not-for-profit health system.

For more information or to arrange an interview, please contact:

Kate Headley, External Communications Coordinator

Canadian Nurses Association

Telephone: 613-237-5129, ext. 561

Cell: 613-697-7507


Website: www.cna-aiic.ca

Last Updated ( Oct 17, 2011 at 09:12 PM )
Nurse Practitioners: Partners in Health Care Transformation, Innovation and Collaboration PDF Print
Oct 23, 2010 at 11:30 AM

Video from NPAO on the Role of the Nurse Practitioner


Last Updated ( Nov 18, 2011 at 11:26 AM )
The Role of the Nurse Practitioner in Canada - The Link, CBC Radio Canada International PDF Print
Jul 22, 2010 at 11:23 AM

Radio interview July 20, 2010 on The Link with Carmel Kilkenny/Marc Montgomery.

The Role of the Nurse Practitioner in Canada

Click on picture below to listen to podcast

The Link


Last Updated ( Jul 22, 2010 at 11:28 AM )
Canadian Association of Schools of Nursing (CASN) Not Supportive of Clinical Practice Doctorate PDF Print
Sep 22, 2009 at 09:26 AM

See Position Statement from CASN Below

send comments to CASN Executive Director Cynthia Baker at:



Last Updated ( Mar 14, 2010 at 12:03 AM )
The Practice Doctorate: Where Do Canadian Nursing Leaders Stand? PDF Print
Jul 04, 2009 at 02:00 AM

The Practice Doctorate: Where Do Canadian Nursing Leaders Stand?

The Practice Doctorate: Where Do Canadian Nursing Leaders Stand?

This article calls upon Canadian nursing leaders to examine the merits and downsides of the new practice doctorate degree - the Doctor of Nursing Practice (DNP). The impetus for the DNP arose from within the American nursing profession in order to address the knowledge and skills needed by advanced practice nurses to work in today's complex healthcare environment. The DNP is the newest practice doctorate degree and in 2015 will be the entry to practice degree required of all new advanced practice nurses in the United States. Advanced practice nurses who will have the practice doctorate include clinical nurse specialists, nurse practitioners, nurse midwives and nurse anaesthetists. With the establishment and acceptance of the DNP in the United States, American advanced practice nurses will have a different knowledge base than Canadian advanced practice nurses.

The evolution and state of advanced practice nursing in Canada are discussed in this article. Canadian nursing leaders must discuss the DNP, its merits and downsides within the Canadian context and begin to make informed decisions about whether or not the DNP should come to Canada.

Last Updated ( May 07, 2010 at 11:18 PM )
Sudbury District Nurse Practitioner Clinic Website PDF Print
Jan 23, 2009 at 12:30 PM

Visit the Sudbury District Nurse Practitioner Clinic Website
Click Here


Last Updated ( Jul 04, 2009 at 08:33 PM )
Welcome to NPCanada.ca PDF Print
Mar 25, 2007 at 05:59 PM
Welcome to NPCanada.ca

Advanced Practice Nursing (APN), and more specifically the Nurse Practitioner, has traditionally been practiced in northern parts of Canada. Nurses would take courses to advance their skills or they would learn on-the-job. Recently (in the last decade), legislation has been implemented to allow nurses with advanced education (Masters of Nursing in Advanced Practice) to practice in a Nurse Practitioner or Advanced Practice role in settings other than northern communities. 

What can a Nurse Practitioner do? In most provinces in Canada, legislated Nurse Practitioners are able to diagnose and manage many disorders and chronic diseases, prescribe medications for you, order diagnostics, and refer you to specialists if needed. They are able to do complete physicals, and medicals required for most third party companies, and care for you during your pregnancy and after you deliver. They see many clients with chronic diseases like diabetes, hypertension, heart failure, osteoarthritis, and mental health concerns. They also see patients when they are acutely ill such as in Emergency Departments or in Critical Care units. In primary care settings, Nurse Practitioners are able to see you the same day if you have an earache, sore throat, or other condition that is keeping your from work or school. Some Nurse Practitioners are also able to perform minor surgical procedures. Please call your provincial nursing regulatory body  or your regional health authority to locate a Nurse Practitioner in your area.

As it stands today, all provinces and territories have legislation that allows Nurse Practitioners to practice to their full scope.

Provinces and Territories vary on what type of legislation they have in place for NPs. The Canadian Nurse Practitioner Exam (CNPE) is one step toward national recognition of the Nurse Practitioner  however, not all provinces require this exam for entry to practice. For further details on what requirements are needed for entry to practice in the various provinces/territories click here.

NPCanada.ca is a website designed to provide a forum for discussion of issues related to Advanced Practice Nursing in Canada. Although there are many NP sites on the internet, most are American or from the UK. These resources are excellent, but practicing as an NP in Canada is very different. Legal, education and practice issues in the UK or US are unlike those encountered here in Canada. With the ability to share ideas and information on these issues, it is hoped that the profession of Advanced Practice Nursing will be promoted in Canada.

Dr. Donna Alden-Bugden, RN(EP, Manitoba), NP-C (Minnesota), FNP-BC(Minnesota), MN, DNP
Family Nurse Practitioner - Minnesota, Manitoba


View Donna Alden-Bugden, NP-C, FNP-BC, DNP (c)'s profile on LinkedIn

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Last Updated ( Mar 23, 2013 at 07:39 PM )
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