Understanding Thyroid Disease
Perhaps everyone is familiar with goiter. It is somewhat easy to spot a person who has it, because it affects the appearance around the neck area. What is not widely understood is that goiter is only one of several health problems brought on by hypothyroi
According to the Mayo Clinic, women – especially those older than age 60 – are more likely to have hypothyroidism, a condition that upsets the normal balance of chemical reactions in the body. It seldom causes symptoms in the early stages, the Mayo Clinic adds, but over time, untreated hypothyroidism can cause a number of health problems, including obesity, joint pain, infertility and heart disease.
Fortunately, modern thyroid function tests are available and highly accurate in diagnosing hypothyroidism, and treatment of hypothyroidism with synthetic thyroid hormone is usually simple, safe and effective once the doctor find the right dose for the patient.
The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. In general, though, the problem tends to develop slowly, often taking a number of years. During the initial stage, symptoms are barely noticed; early symptoms such as fatigue and weight gain may simply be regarded as part of getting older.
But as one’s metabolism continues to slow down because of the condition, more obvious signs and symptoms may occur. These may include fatigue, increased sensitivity to cold temperatures, constipation, dry skin, weight gain, puffy face, hoarseness of voice, muscle weakness, increased blood cholesterol level, muscle aches, tenderness and stiffness; pain, stiffness or swelling in the joints, heavier than normal or irregular menstrual periods among women, thinning hair, slowed heart rate, depression, and impaired memory.
Also, when hypothyroidism isn’t treated, the constant stimulation of the thyroid gland to release more hormones may lead to an enlarged thyroid (goiter). Advanced hypothyroidism, known as myxedema, is rare, but the Mayo Clinic emphasizes that when it occurs it can be lifethreatening. Symptoms of myxedema include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma.
Julia Naftulin, in an article at www.health.com, cites some experts saying that a woman over the age of 35, is 30 percent more likely to develop a thyroid disorder. The higher risk among women may be attributable to various factors, including genetics, an autoimmune attack, pregnancy, stress, nutritional deficiencies, or toxins in the environment.
While thyroid problems are real and should be dealt with seriously, it is often made worse by myths about the condition. Naftulin quotes thyroid experts trying to separate fact from fiction about hypothyroidism:
Myth: If you have a thyroid problem, you’ll definitely know it.
Fact : “Thyroid-related symptoms can be present in many different medical conditions,” says Dorothy Fink, MD, endocrinologist and assistant professor of medicine at NYU Langone Medical Center in New York City. Dr. Fink says thyroid disorders are often misdiagnosed particularly in women, because other female-specific, hormonerelated conditions can have similar symptoms, including premenstrual dysphoric disorder, perimenopause, or menopause. Simply being overweight can create symptoms that mirror those of thyroid diseases as well, Dr. Fink notes.
Myth: Only older women can develop thyroid problems.
Fact : Thyroid disease can affect men and women at any age. However, older women do have a higher chance of developing a thyroid problem, says Dr. Fink. She says, “…genetics plus environmental factors are usually what tip someone over into developing an autoimmune-related underactive or overactive thyroid condition. It can present across any age, but it has a predilection for women.”
Endocrinologist Christian Nasr, MD, at the Cleveland Clinic, says women are more likely to develop thyroid conditions because they have higher estrogen levels than men. “Estrogen makes the cells more visible to the immune system, so women tend to be more affected by all thyroid conditions – hypothyroidism, hyperthyroidism, nodules, and thyroid cancer,” Dr. Nasr says.
Myth: Consuming extra iodine will improve your thyroid health.
Fact : The thyroid needs iodine to function properly – but most people today have no problem getting enough of it. Taking supplements or eating a ton of seaweed could actually do the thyroid more harm than good, Dr. Fink says. Excess iodine can trigger thyroid dysfunction: “If you don’t have the proper mechanisms working in your thyroid to shut it down when it’s overdosed on iodine, it will turn into this iodineusing factory and keep churning through all this iodine and make too much thyroid hormone,” she says. “It can cause an overactive thyroid (hyperthyroidism) if you really overdose on it.”
Myth: Gluten sensitivity can trigger thyroid disease.
Fact : “Graves’ disease and thyroid cancer are not going to get better by staying away from gluten,” says Dr. Nasr. “If someone has a family history of Hashimoto’s or hypothyroidism – because that’s the strongest factor – it likely won’t make a difference.”
However, Dr. Nasr says celiac disease is common in people with autoimmune diseases like Hashimoto’s and Graves’. If one has both a thyroid condition and a gluten sensitivity, it makes sense to remove gluten from the diet – but the thyroid problem won’t improve because of the diet restrictions. “The antibodies from the thyroid do not come down and become normal on a gluten-free diet,” says Dr. Fink. “We don’t treat based on an antibody level. If your antibody level and thyroid condition is positive, it’s positive.”
Myth: Doing headstands will alleviate your thyroid disease symptoms.
Fact : There’s a myth that doing headstands or other inverted yoga poses alleviates thyroid disease symptoms by increasing blood flow to the gland. And sure, yoga can strengthen the body and soothe mind, but the truth is, no number of downward dogs will cure a thyroid condition or prevent one from occurring. Still, Dr. Fink and Dr. Nasr say, if inversions make one feel healthy, then he or she shall go for it. Plus, daily yoga could help the symptoms in other ways. “I would assume someone who is doing yoga is less stressed,” says Dr. Fink, “and losing weight would benefit because if you weigh less, you can take less thyroid hormone.”
Myth: If you have a lump on your neck, you definitely have a thyroid problem.
Fact : A lump on the neck is not necessarily a goiter (enlarged thyroid). “While the thyroid is the most common thing that can enlarge in your neck, there are a lot of other things in the neck besides the thyroid,” says Dr. Fink.
Other causes of a neck lump could be a swollen lymph node or cyst. Either way, Dr. Fink recommends that the person gets any neck lumps checked out by a doctor, who will evaluate the problem (or lack thereof) with a quick exam and order up ultrasounds or CT scans, if necessary.
Myth: If a person is tired and gaining weight, there’s definitely something wrong with her thyroid.
Fact : “The symptoms of an underactive thyroid are very non-specific, meaning they can present with many different conditions,” says Dr. Fink. “I always tell patients I’m looking at them as a whole person, not just their thyroid gland, even though they may come to me saying they have a thyroid problem.”
For female patients, Dr. Fink first looks at the menstrual cycle, which often causes symptoms similar to those found in thyroid disease patients. “Symptoms like fatigue and weight gain can come up with a thyroid condition or with a menstrual cycle,” says Dr. Fink. “One good trick is to find a good app to track your period and that can help us sometimes understand their bodies better and the daily fluctuation of hormones.” If your period isn’t to blame for tiredness or a few extra pounds, Dr. Fink says a TSH test is the next step in diagnosing a true thyroid condition.
Myth: Thyroid disease is easy to treat.
Fact : Thyroid conditions aren’t “easy” to treat, but treatment isn’t that complicated either, says Dr. Fink. She says most people with thyroid disease are prescribed medication to replace T4, one type of thyroid hormone that a faulty thyroid is unable to produce on its own. Then, the thyroid gland is able to convert the T4 into T3, the other needed hormone, on its own – even in someone with a thyroid condition.
Dr. Fink says patients only encounter problems when they ask for a T3 medication, too. “A lot of stuff online talks about giving T3 and it gets very complicated because when you give someone the T3. It goes in the body and comes almost straight out,” she says. “It almost gives people a high, and lot of people can get addicted to it.” To make matters worse, Dr. Fink says T3 prescriptions can lower the thyroid’s ability to produce T4 on its own, resulting in an overactive thyroid.
Myth: Removing metallic foods and elements from one’s diet can alleviate thyroid problems.
Fact : Avoiding processed foods is always a smart move, says Dr. Fink. At the same time, there’s no convincing research that suggests one needs to obsess over the metals she’s consuming, so she need not toss her copper and steel pots and pans just yet.
The same goes for those silver fillings your dentist put in your mouth: “I can’t say based on what I know now that this will predispose you to a thyroid condition. I wouldn’t suggest going to the dentist and getting your fillings removed for now,” Dr. Fink adds.
Myth: Eating any soy-based products can cause thyroid problems.
Fact : Soy does have an affect on the thyroid, but hypothyroid tofu lovers don’t need to totally abstain from soy-based foods to maintain healthy hormone levels. Dr. Fink says soy, when eaten often, can decrease absorption of the prescribed thyroid hormones hypothyroid patients need. “In general, I tell patients with hypothyroidism they don’t need to completely avoid these things, but overdosing on them could create an issue,” she says.
So, what does the doc recommend for soy eaters? “People can have their thyroid medicine in the morning and have tofu for dinner a few times a week and be totally fine,” Dr. Fink says.