Spot the signs of thy­roid prob­lems

Irish Examiner - Feelgood - - Health -

TYROID dis­or­ders are be­lieved to af­fect around one in 20 peo­ple, yet be­cause the symp­toms — such as weight changes, de­pres­sion and fa­tigue — can of­ten be vague (or over­lap with other con­di­tions), it’s not un­com­mon for thy­roid dis­or­ders to go un­de­tected for a long time.

“The only way to be sure you have a thy­roid con­di­tion is with blood tests, as the symp­toms can be quite vague and aren’t spe­cific,” says Dr Steven Hurel, a con­sul­tant en­docri­nol­o­gist.

Here are some im­por­tant points about the thy­roid gland and thy­roid dis­or­ders...

1. Where is the thy­roid?

Dr Hurel ex­plains that the but­ter­fly-shaped thy­roid gland lies at the front of the neck (just be­low the Adam’s ap­ple), and is part of the en­docrine sys­tem (the sys­tem re­spon­si­ble for pro­duc­ing hor­mones).

2. What does it do?

The thy­roid pro­duces the hor­mones T4 (levothy­rox­ine) and T3 (lio­thy­ro­nine) that reg­u­late the body’s metabolic rate as well as heart and di­ges­tive func­tion, mus­cle con­trol, brain de­vel­op­ment, mood, and bone main­te­nance.

3. Screen­ing for thy­roid prob­lems

TSH (thy­roid stim­u­lat­ing hor­mone) is made by the pi­tu­itary gland in the brain, and stim­u­lates the thy­roid gland to pro­duce both hor- mones. Mea­sur­ing TSH is used as a screen­ing method for thy­roid prob­lems. If thy­roid func­tion fails, TSH rises — and if the thy­roid stops pro­duc­ing enough thy­rox­ine, then the TSH rises fur­ther and hy­pothy­roidism (un­der­ac­tive thy­roid) de­vel­ops.

4. Fam­ily his­tory can count

Thy­roid prob­lems of­ten run in fam­i­lies, so if one of your close blood rel­a­tives has been di­ag­nosed, you might be more likely to de­velop a thy­roid dis­or­der too - although this is not al­ways the case. Tyroid is­sues are more com­mon in women.

5. Have you got hy­pothy­roidism?

Hy­pothy­roidism symp­toms in­clude fa­tigue, lethargy, cold in­tol­er­ance, dry skin, brit­tle hair, weight gain, a hoarse voice, con­sti­pa­tion, lower li­bido, mus­cle weak­ness, heav­ier pe­ri­ods, a puffy face and bags un­der the eyes, slow speech, move­ments and thoughts, de­pres­sion, mem­ory prob­lems, dif­fi­culty con­cen­trat­ing, a slow heart­beat, slightly raised blood pres­sure and raised choles­terol.

6. Im­mune in­volve­ment

There are dif­fer­ent types and causes for thy­roid dys­func­tion. Au­toim­mune thy­roid dis­ease, where the im­mune sys­tem at­tacks the thy­roid cells, is the big­gest cause of hy­pothy­roidism. The most com­mon form is Hashimoto’s thy­roidi­tis.

7. Get­ting the bal­ance right

Hy­pothy­roidism is treated with syn­thetic levothy­rox­ine.

8. Be­ware of grape­fruit

Grape­fruit is known to in­crease the ab­sorp­tion of levothy­rox­ine, as it in­creases acid­ity in the stom­ach.

9. And be care­ful with cough medicine

Some cough medicines con­tain­ing large amounts of io­dine can in­ter­fere with thy­roid func­tion too.

10. Go easy on the sea­weed

Some health foods taken in ex­cess — for ex­am­ple, kelp, a form of sea­weed — can cause hy­pothy­roidism.

11. Brain mal­func­tion may be a fac­tor

Hy­pothy­roidism can also be caused by a mal­func­tion of the pi­tu­itary gland in the brain, which reg­u­lates thy­roid hor­mones.

12. Con­gen­i­tal hy­pothy­roidism can also hap­pen

Some­times ba­bies are born with hy­pothy­roidism, pos­si­bly be­cause the thy­roid hasn’t de­vel­oped or be­cause it doesn’t form thy­roid hor­mones prop­erly. This is known as con­gen­i­tal hy­pothy­roidism.

13. Over­ac­tive thy­roid

The thy­roid gland can also be­come over­ac­tive, so TSH usu­ally falls and be­comes un­de­tectable, as the body tries to stop the thy­roid from work­ing. This is hy­per­thy­roidism, which leads to an in­crease in me­tab­o­lism.

14. Have you got hy­per­thy­roidism?

Hy­per­thy­roidism symp­toms can in­clude weight loss de­spite an in­creased ap­petite, pal­pi­ta­tions/a rac­ing heart, sweat­ing and heat in­tol­er­ance, tired­ness and weak mus­cles, ir­ri­tabil­ity, shak­i­ness, mood swings, thirst, loose bow­els, thy­roid eye dis­ease (prom­i­nent eyes that feel gritty and sore, dou­ble vi­sion), and an en­larged thy­roid gland. Symp­toms may be sub­tle and un­no­ticed for a long time, but they can also come on sud­denly and se­verely.

15. Graves’ dis­ease

When hy­per­thy­roidism is as­so­ci­ated with thy­roid an­ti­bod­ies in the blood, it’s known as Graves’ dis­ease, an au­toim­mune con­di­tion where the im­mune sys­tem at­tacks the thy­roid gland, which be­comes over­ac­tive in re­sponse.

16. Stress can be a trig­ger

Peo­ple with Graves’ dis­ease may have ex­pe­ri­enced ma­jor stress a year or so be­fore their di­ag­no­sis. It’s be­lieved that for a var­i­ous au­toim­mune con­di­tions, peo­ple who are pre­dis­posed can de­velop them fol­low­ing ex­po­sure to a ‘trig­ger’.

Although very com­mon, dis­or­ders in this vi­tal gland can be tough to spot and are of­ten mis­un­der­stood. Lisa Salmon finds out more

HARD TO SWAL­LOW: Thy­roid dis­or­der symp­toms are vague and of­ten go un­de­tected.

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