Thyroid Awareness - January 19, 2010 Newsletter

Thyroid Awareness Month

EHE Newsletter, Volume 10, Number 3
January 19, 2010

It is estimated that more than 27 million Americans have some form of thyroid dysfunction. Of those 27 million people, more than half remain undiagnosed because thyroid problems can easily be confused with other conditions. January is Thyroid Awareness Month, a time in which individuals can become more knowledgeable about thyroid conditions and take necessary steps to ensure thyroid health.

What is the Thyroid?

The thyroid is a small, butterfly–shaped gland located in the lower front of the neck, above the collarbones and below the voice box (larynx). It is a part of the endocrine system. The function of the thyroid is to regulate the body’s metabolism — the process by which oxygen and calories are converted to energy for use by cells and organs. The thyroid regulates metabolism by taking in iodine (obtained through food, iodized salt, or supplements) and combining it with the amino acid tyrosine. The thyroid then converts the iodine and tyrosine into the hormones triiodothyronine (T3) and thyroxine (T4). T3 and T4 are then released into the bloodstream and transported throughout the body to control metabolism. Every cell in the body depends upon thyroid hormones for regulation of its metabolism. These hormones enable our body to use its stores of energy efficiently, thereby controlling temperature and allowing muscles to function properly.

The thyroid gland is controlled by the pituitary gland (the principal function of which is to monitor and regulate the activity of the other glands). The pituitary gland is located at the base of the brain and produces thyroid–stimulating hormone (TSH). The bloodstream carries this TSH to the thyroid gland where it ‘tells’ the thyroid how much thyroid hormone to produce.

A properly–functioning thyroid will maintain the right amount of hormone production needed to keep the body’s metabolism functioning at a satisfactory rate. Thyroid dysfunction occurs when the thyroid gland produces either too much or too little thyroid hormone. If the thyroid is overactive, the gland releases too much thyroid hormone into the bloodstream, resulting in a condition called hyperthyroidism. If the thyroid is underactive, it produces too little thyroid hormone, resulting in a condition called hypothyroidism.

Hyperthyroidism

When hyperthyroidism occurs, the body uses energy faster than it should. Approximately one percent of the U.S. population has hyperthyroidism. It affects women five–to–ten times more often than men, with women between the ages of 20 and 40 being the most commonly diagnosed. In more than 70 percent of cases, hyperthyroidism is caused by an autoimmune disorder called "Graves’ disease". With Graves’ disease, antibodies produced by the immune system stimulate the thyroid, causing it to produce excess hormone. Other common causes for hyperthyroidism are hyper–functioning thyroid nodules and thyroiditis. Hyper–functioning thyroid nodules occur when one or more nodules or lumps in the thyroid grow and increase their activity, resulting in the excess production of hormones. Thyroiditis occurs when a problem with the immune system, or a viral infection, causes the thyroid gland to become inflamed; stored thyroid hormone then leaks out of the inflamed gland and raises hormone levels in the blood.

According to American College of Endocrinology (ACE), the educational and scientific arm of the American Association of Clinical Endocrinologists (AACE), when hyperthyroidism develops, a goiter (enlargement of the thyroid) is usually present and may be associated with some or many of the following occurrences:

• Fast heart rate, often more than 100 beats per minute
• Anxiousness, irritability, argumentativeness
• Trembling hands
• Weight loss, despite eating the same amount or even more than usual
• Intolerance of warm temperatures and increased likelihood of perspiration
• Loss of scalp hair
• Tendency of fingernails to separate from the nail bed
• Muscle weakness, especially of the upper arms and thighs
• Loose and frequent bowel movements
• Smooth skin
• Change in menstrual pattern
• Increased likelihood of miscarriage
• Prominent "stare" of the eyes
• Protrusion of the eyes, with or without double vision (in patients with Graves’ disease)
• Irregular heart rhythm, especially in patients older than 60 years of age
• Accelerated loss of calcium from bones (which increases the risk of osteoporosis and fractures)

In its mildest form, hyperthyroidism may not cause recognizable symptoms. More often, however, the symptoms are discomforting, disabling or even life–threatening.

There are three common treatment options for hyperthyroid disorders: anti–thyroid medications, radioiodine therapy and surgery. If left untreated, hyperthyroidism can lead to other health problems including congestive heart failure and osteoporosis.

Hypothyroidism

When hypothyroidism occurs, the body uses energy slower than it should. Hypothyroidism can be caused by several conditions including Hashimoto’s disease (also called "Hashimoto’s thyroiditis" or "autoimmune thyroiditis"), radioactive iodine treatment, a thyroid operation, certain medications, subacute thyroiditis, postpartum thyroiditis, silent thyroiditis, congenital hypothyroiditis, and pituitary hypothyroiditis. Hashimoto’s disease is the most common cause of hypothyroidism in the United States. It is an autoimmune disease that causes chronic inflammation of the thyroid gland which results in damage to the gland and reduced thyroid function. The thyroid gland may also enlarge, forming a goiter. Hashimoto’s disease is an inherited condition that affects approximately 14 million Americans and is about seven times more common in women than in men.

According to ACE, in its earliest stage, hypothyroidism may cause few symptoms because the body has the ability to partially compensate for a failing thyroid gland by increasing stimulation to it. As thyroid hormone production decreases and the body’s metabolism slows, however, a variety of symptoms may result including:

• Pervasive fatigue
• Drowsiness
• Forgetfulness
• Difficulty with learning
• Dry, brittle hair and nails
• Dry, itchy skin
• Puffy face
• Constipation
• Sore muscles
• Weight gain and fluid retention
• Heavy and/or irregular menstrual flow
• Increased frequency of miscarriages
• Increased sensitivity to many medications

Hypothyroidism is generally treated by replacing the thyroid hormone that the body needs with an oral tablet or pill of the thyroid hormone thyroxine (T4, or "levothyroxine"). The symptoms of hypothyroidism are unpleasant and can affect an individual’s self–esteem, work, home and family life. If left untreated, it can cause serious complications and become life–threatening. Severe complications of hypothyroidism include:

• A heart rate so slow that it can cause patients to slip into a coma
• Higher blood pressure and elevated cholesterol levels which are significant risk factors of heart disease
• Infertility
• An increased risk of Alzheimer’s disease in women

Many individuals remain undiagnosed with thyroid problems and can suffer for a long time as their symptoms are confused with other conditions such as depression, obesity or menopause. Thyroid dysfunction can be confirmed by a doctor through a simple blood test to check the levels of thyroid stimulating hormone (TSH) and thyroid hormones in the blood. Individuals should talk to their doctors for more information as effective treatment is available to reduce the risks of serious complications.

MEDICAL DISCLAIMER: The information is not intended to constitute medical advice and is not a substitute for consultation with a physician or other health care provider. Individuals with specific complaints should seek immediate consultation from their personal physicians.