Thyroid Disease-What Women Need to Know?


By Dr. Sherry Ross

In honor of Thyroid Awareness Month I wanted to share some important information regarding Thyroid disease.

I think it was Oprah who really brought needed attention to this very small hormone gland in our neck, called the thyroid gland, when she attributed her weight gain to the fact that her thyroid was not working correctly. Most women would love to make the same association to why they have gained that extra 10-15 pounds. Even if your weight gain cannot be linked to your thyroid it’s important to know that thyroid disease is serious and often underdiagnosed. Thyroid disease is very common in women affecting 1 in 8 but undiagnosed in 1 in 20 women. Women of all ages, including teens, should be tested if symptoms of an abnormal functioning thyroid appear.

What is the function of thyroid gland?

The thyroid gland produces, stores and releases hormones that control your metabolism. Ideally you want your thyroid to maintain a steady control of your metabolism rate—not too fast and not too slow. You metabolism controls the rate of how your body actually works. For example, a fast metabolism means your body works at a much fast rate burning more calories and having a faster heartbeat. Thyroid hormones keep us physically and emotionally balanced. There are certain medical conditions and medications that can cause the thyroid gland to make too much or too little hormones.

How is thyroid disease diagnosed?

As you will see the symptoms of an abnormal thyroid gland can be easily attribute to other medical conditions. If there is any clinical suspicion that you are experiencing any of the symptoms of an abnormal thyroid gland getting tested is easy. Seeing your health care provider is a must. It’s so important to be your own health care advocate.

  • Symptoms include fatigue, unusual weight gain or loss, rapid or slow heartbeat, feeling unusually cold or hot, constipated or diarrhea, hair loss, increased sweating, changes in your menstrual periods, changes in mood are the more common symptoms.
  • Physical exam of the thyroid can show the gland to be enlarged or irregularly shaped. Thyroid nodules are typically benign and often need a biopsy for diagnosis.

Making the diagnosis can be easy—a simple blood test gives you everything you need to know. Early detection is crucial!

  • A Thyroid blood panel that includes thyroid stimulating hormone (TSH) and tetraiodothyronine (T4), along with thyroid antibodies.
  • Thyroid US is performed on an enlarged or irregular shaped thyroid gland.
  • Thyroid Scan involves radioactive iodine (it’s very safe!) showing how well the thyroid absorbs the iodine. There can be areas of underactive or overactive absorption showing an abnormally function thyroid gland.

What is Hypothyroidism? (Underactive thyroid)

When your thyroid gland does not make enough thyroid hormones to maintain your normal body metabolism this is called hypothyroidism. Causes of hypothyroidism tend to be due to inflammation of the thyroid gland. The most common cause is called Hashimoto’s disease. Our immune system (our body’s natural defense against disease) mistakes cells in the thyroid gland for harmful invaders. Our body sends out white blood cells to destroy the thyroid gland. The pituitary gland (another hormone producing gland in our brain) releases TSH to tell the thyroid gland to make more hormones. This demand on the thyroid gland can cause it to enlarge. This enlargement is called a goiter. Another rare cause (especially in the US) of hypothyroidism in not getting enough iodine from our diet.

Symptoms can affect virtually any and every organ system and include:

  • Fatigue
  • Weight gain
  • Decreased appetite
  • Heavy and irregular menstrual periods
  • Loss of sex drive
  • Feeling cold when others do not
  • Constipation
  • Muscle aches, weakness and tenderness
  • Puffiness around the eyes
  • Brittle nails
  • Thin and brittle hair
  • Dry skin
  • Hoarseness
  • Slow heart rate
  • Depression
  • Elevated LDL (the bad) cholesterol levels

Hypothyroidism in children and teens will show many of the symptoms but also experience other symptoms that include:

  • Poor growth, resulting in short stature
  • Delayed development of permanent teeth
  • Delayed puberty
  • Poor mental development

Treatment for Hypothyroidism includes medication that contains thyroid hormone. Treatment using synthetic thyroid hormone is usually simple, safe and effective once you are on the right dose. Monitoring your thyroid hormones a couple times a year will help you know that gland is functioning normally.

What is Hyperthyroidism? (Overactive thyroid)

When your thyroid gland makes too much thyroid hormone, hyperthyroidism occurs. The most common cause of hyperthyroidism is a disorder known as Graves’ disease affecting women 20-40 years. Certain medications, such as Lithium, can also make the thyroid gland overactive.

Symptoms include:

  • Fatigue
  • Weight loss
  • Nervousness, anxiety and irritability
  • Change in menstrual periods
  • Rapid or irregular heart beat
  • Feeling hot when others do not
  • Tremors
  • More frequent bowel movements
  • Bulging eyes (late sign of Graves’ disease)

Treatment for Hyperthyroidism include medication to reduce the amount of thyroid hormone your body is making. Sometimes medication doesn’t control the production of excessive thyroid hormone and high-dose radioactive iodine is needed to regulate the gland. Surgery is a last resort when other treatments fail.

What is done for Thyroid Nodules?

When a thyroid nodule is found on physical exam, an ultrasound of the thyroid gland is performed. A fine needle aspiration (FNA) or biopsy of the nodule is always performed to make sure the nodule is benign and not cancerous. Most thyroid nodules are benign and do not have any other symptoms associated with them.

Regular routine screening for thyroid disease should be done every 5 years starting at 50 years. Women who are at risk, are symptomatic, pregnant, or have a family history should be screened sooner.

Fortunately medical conditions of the thyroid are treatable diseases. Once the diagnosis is made most women are relieved that they have an explanation for the way they have been feeling. Do not be one of the 13 million women undiagnosed for thyroid disease. Treatment is mentally, physically and emotionally gratifying.

Posted in: Let's Talk Women's Health

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