Practical Prevention-Thyroid Disease

Thyroid Trouble: More Common Than You Might Think

Over the years I've met many people with thyroid disease. It's probably the most frequent hormone problem I deal with as a family physician. It's also one of the most under-diagnosed and under-treated diseases in America today.

The reasons for this are simple: Thyroid disease can sneak up on you slowly and subtly. And the symptoms it causes are vague, easily confused with other health problems, or not present at all. As a result, more than 13 million Americans with a thyroid condition are not aware of the problem.

Women More at Risk

By some estimates, thyroid disorders occur about five times more often in women than men. And the incidence increases with age. In a recent study of 25,000 healthy people attending the Colorado State Health Fair, 4% of women ages 18-24 had evidence of thyroid disease. The numbers climbed gradually, reaching a whopping 21% of women over age 75. And these were "healthy" people who were not aware they had any health problems.

What Is the Thyroid?

Your thyroid is a butterfly-shaped gland just below the Adam's apple at the base of your neck. It secretes a hormone called thyroxin that regulates your metabolism—the rate at which every part of your body works. As a result, this hormone can affect your energy level as well as your health from head to toe.

Thyroid Disorders

The two most common thyroid disorders are:

Hypothyroidism (underactive thyroid)
This condition occurs when your thyroid doesn't produce enough thyroxin hormone, causing your metabolism to slow down.

Symptoms of an underactive thyroid include:

• Fatigue
• Depression
• Unexplained weight gain
• Dry skin
• Hair loss
• Intolerance to cold

In addition, hypothyroidism can contribute to:

• High cholesterol
• Memory problems
• Irregular periods
• Swelling of the face or extremities

Hyperthyroidism (overactive thyroid)
This condition occurs when your thyroid makes too much thyroxin hormone, causing your metabolism to speed up.

Symptoms of an overactive thyroid include:

• Nervousness
• Mood swings
• Insomnia
• Unexplained weight loss
• Weakness
• Tremors
• Heat intolerance
• Excessive sweating
• Palpitations
• Shortness of breath

Preventing Complications of Thyroid Disease

Without treatment, thyroid disorders can lead to serious health problems. A high cholesterol level, commonly associated with even mild hypothyroidism, can contribute to heart attacks and hardening of the arteries.

Hyperthyroidism, or too much thyroid hormone, may result in:

• Osteoporosis
• Premature births or miscarriages among pregnant women
• Irregular heart beat
• Heart failure
• Stroke

These problems can be minimized when you catch a thyroid problem early. A simple blood test diagnoses most common thyroid diseases. The thyroid-stimulating hormone (TSH) test is safe, accurate, widely available, and relatively inexpensive. The American Thyroid Association (ATA) says TSH testing is as cost-effective as screening tests for high blood pressure, cholesterol and breast cancer. And, in older women, it's even more so.

Who Should Be Tested?

If you're over age 34—especially if you're a woman—I advise asking your health care provider about thyroid disease. Currently, there is controversy about when and how often to conduct screening. The ATA recommends that all adults receive a TSH test every five years starting at age 35.

You may need to be tested more frequently, says the ATA, if you have symptoms or risk factors for thyroid disease. These include:

• Previous thyroid problems or goiter (an enlarged thyroid)
• Surgery or radiation therapy affecting the thyroid gland
• Diabetes
• Vitiligo (white skin patches)
• Pernicious anemia (from vitamin B12 deficiency)
• Prematurely gray hair
• Use of certain medicines (thyroid medication, lithium, iodine-containing compounds)
• High cholesterol or calcium
• Low sodium
• Anemia
• Elevated liver enzymes
• Family history of diabetes, pernicious anemia, adrenal problems or thyroid disease

Consider getting your thyroid checked. If you do have a thyroid disorder, there are medications to correct the problem.