MEDICALLY SPEAKING: Thyroid: A little gland that can cause big problems
The thyroid is a small, butterfly-shaped gland just above the collarbone. Controlled by the brain's pituitary gland, which produces thyroid stimulating hormone (TSH), the thyroid is responsible for manufacturing hormones T3 and T4. These hormones regulate metabolism, the rate at which the body uses energy from food. If the thyroid goes haywire, metabolism speeds or slows.
A friend of mine recently began treatment for subclinical (mild) hypothyroidism, a condition in which the thyroid does not produce enough T3 and/or T4."I thought two-hour naps almost every day were just me being me, but since I've started treatment I can work all afternoon without feeling sleepy. I'm a lot more productive, and I feel much better," she tells me.
Symptoms of hypothyroidism may include fatigue, weight gain, depression, intolerance to cold temperatures, dry skin and hair, and constipation. Perhaps the most concerning aspect of the disorder was highlighted in a study presented at the recent American Thyroid Association annual meeting indicating that older people with mild hypothyroidism are twice as likely to develop congestive heart failure as people with normal thyroid function. Another study, published in a recent issue of the Archives of Internal Medicine, found that "as thyroid function drops, blood pressure and cholesterol levels rise as does the risk of heart problems."
The TFA recommends testing thyroid levels at least every five years for people 50 and older. A simple blood test can determine the levels of TSH, T3 and T4. If levels are outside normal ranges, a variety of treatments, including thyroid replacement therapies using synthetic or natural forms of T3 and T4, are available. Proper treatment has been shown to decrease cholesterol and blood pressure and encourage weight loss.
The flip side of an underactive thyroid is the production of too much thyroid hormone, a condition called hyperthyroidism. This disorder often affects women between the ages of 20 and 40 and can be marked by trembling, muscle weakness, rapid heartbeat, fatigue, weight loss, diarrhea, irritability, vision problems, menstrual irregularities, perspiration and infertility.
Treatment for hyperthyroidism may involve drugs that decrease thyroid production and beta blockers to control symptoms. In some cases, the thyroid must be permanently shut down by surgically removing it or destroying it with a radioactive form of the mineral iodine.
If you don't feel well, talk to your primary care physician. Thyroid disorders are not uncommon and are very treatable given accurate diagnosis. With some medicine and your doctor's observation, you can be feeling better before you know it.
Dr. Anthony Jennings is director of the Department of Emergency Medicine at SSM St. Joseph Hospital West in Lake Saint Louis. He is board-certified in emergency medicine and has achieved fellowship status in the American College of Emergency Physicians and the American College of Osteopathic Emergency Physicians.
