Monday, June 1, 2009

Addendum to Children -- The Growing up years -- Growing into Womanhood

Topaztook added a comment that I wanted to emphasize. If a girl or even an older woman has several difficult periods in a row, it's wise to get the thyroid checked. I know I've mentioned this for adult women several times, but I hadn't thought to stress that a mother might want to ask her daughter's physician if the daughter is experiencing menstral difficulties. Many girls have unusual cycles in the first few years of menstruation, and this is not usually due to thyroid problems. However, it can be. Thyroid conditions are more common in mid-life and beyond; however, younger girls and women can develop thyroid issues, and it's always wise to have that checked.

During a general check-up, a doctor often feels the thyroid gland to check for problems with enlargement. However, for some reason, blood tests for thyroid problems are not generally done as a routine screening, and a thyroid problem usually shows up in the blood long before a hardening or enlargement of the gland is felt. Therefore, if you suspect that you or a child have a thyroid problem, you may specifically need to ask for a test.

The reason this is so important to me is that I struggle with (probably autoimmune) hypothyroid issues, and I know that an under or over active thyroid can affect the body in many ways. My mother and aunt both had thyroid problems, as well, so I am familiar with the symptoms it can cause.

I recently assumed that some issues I was experiencing were simply mid-life issues. However, I am glad I mentioned some of my symptoms to my physician. It seems that a worsening thyroid problem may be a factor, as well.

If you feel unwell for a time, and you don't know why, it's wise to have your thyroid checked. If you have a family history of thyroid problems, this is doubly important. If you are in perimenopause, it's also a good idea to be checked. Don't assume that you do have a thyroid problem simply because you suffer from a few symptoms; many people who think they have thyroid issues turn out to be just fine in that department. If you don't have a genuine thyroid problem, taking thyroid medication can be harmful. On the other hand, if you are feeling symptoms of hypothyroidism, don't ignore them. Let a physician help you sort it all out.

In the past, many women suffered from sub-clinical thyroid issues and many thyroid conditions went undiagnosed and untreated. For example, my mother's thyroid condition had deteriorated quite a bit before she was diagnosed. To be fair, her case was a hard case to diagnose, as the thyroid was failing due to another health problem. However, many women in the past who were experiencing minor hypothyroidism went through life feeling sick and fatigued, but did not receive the treatment they needed. In many cases, physical problems resulting from thyroid conditions were chalked up to laziness, hypochondria, or emotional problems.

Now, the standards for what constitutes hypothyroidism have been reviewed and revised. Many internists and endocrinologists and gynecologists are quicker to recognize borderline thyroid issues in women. They are more likely to start treatment for a slightly failing thyroid before secondary health problems develop.

Under-active thyroid can either cause or be associated with

chronic, deep fatigue, sometimes to the point of being debilitating
skipped periods
heavy or prolonged periods
hormone imbalances
fertility problems
heart disease
thinning hair
a change in facial expression and/or puffiness of the face
cholesterol and blood pressure problems/problems with triglycerides
problems with blood sugar/higher risk for diabetes
weight gain/weight hard to lose despite exercise and diet
sensations of being cold (Though you don't find this in many lists, it's my non-professional opinion that hot flashes can be an issue, as well)
problems with memory and concentration; feeling and actually being mentally sluggish, brain feels "fuzzy", as if you are trying to think in a fog
loss or thinning of outer eyebrows and eyelashes
bowel problems
an enlarged and/or hardened thyroid
nodules on thyroid --usually when not treated in time
other autoimmune diseases
consistently low body temperature
cold feet
(If a person's thyroid continued to fail and the condition went untreated, coma and death could result. This is highly unlikely to happen today, because most people who are headed for such severe thyroid problems receive medical attention long, long, long the before the condition reaches this point.)

Not everyone who has a hypothyroid problems will experience all of the above symptoms. And, it's my non-professional opininon that you can experience some atypical symtoms with thyroid disease. However, if you are hypothyroid, you simply won't feel well or function at your best.

Additionally, an untreated under-active thyroid can produce thyroid hormone in spurts, which means that a person generally has symptoms of too low thyroid hormone punctuated with bouts of hyper-thyroid symptoms. During the hyper-thyroid spells, the person experiences symptoms such as increased energy, anxiety, panic attacks, "the shakes", heart palpitations, a racing heart, and restlessness. This is especially true in the case of Hashimoto's thyroiditis, the most common auto-immune disease of the thyroid. If the spurt of thyroid hormone simply brings you to within the normal range, I suppose you might simply feel a sense of temporarily increased energy and well-being.

Sometimes, only a very small dose of thyroid replacement hormone can make a huge difference in how well your body functions.

I can't say it too much, but it's best not to try to diagnose or to treat yourself for a thyroid condition. Every symptom that is associated with thyroid disease can be caused by something other than the thyroid. For example, you may have a consistently low temperature, but that could be normal for you. Or, you might be seriously fatigued, but that could be due to anemia or some other condition.

If you do suspect you have a problem, ask your doctor to do simple blood tests to determine how well your thyroid is working. If you do have hypo-thyroid problems, it's important to work with your physician, as finding the right dosage for you is a delicate balance. Also, you will need to be evaluated from time to time to make sure that your current dosage is still right for you.

It's also important, if you are told that you do, in fact, have thyroid issues, that you do follow through with your treatment. Ignoring the problem only makes things worse. There are a few situations in which certain specific types of thyroid conditions can resolve themselves, such as a virally induced thyroiditis or a post-pregnancy induced thyroid problem. However, in the majority of cases, once you develop a thyroid issue, you will have it for life. If a temporary case of thyroditis does reverse itself, be happy and enjoy your better health :) -- but also know that you do have a risk factor for developing a more permanent thyroid condition and might need to have it checked again in a few years just to see if things are still in the normal range.

It's tempting if you have mild hypothyroidism to ignore the problem, especially if you have periods of time when you are feeling better. Sometimes, patients who are on very small doses of thyroid hormones wonder if such a small amount really makes a difference. As you can see from the list of problems above, refusing to take thyroid replacement hormone when you need it can be dangerous. There is a famous celebrity who has done just that, claming to have solved her auto-immune thyroid problem with retreat dedicated to rest, stress reduction, and diet -- including lots of soy. (Soy, ironically, is known to inhibit absorption of thyroid replacement hormone.) Amost anyone -- ailing or well -- will feel at least somewhat better after retreating away for a course of rest and healthy living, but that does not mean that an underlying medical condition can be completely cured by these things. In fact, advocates for patients with thyroid disease doubt that this celebrity has permanently reversed her thyroid condition. If she has, she is a rare, rare case. Advocates fear that women who need medical attention will follow the celebritity's example and try to treat themselves.

There's a common belief in the U.S. that if you have a thyroid problem, you need more iodine. It's true that in the third world, there are people who do lack iodine and who do suffer thyroid problems as a result. If you live in an area where iodine deficient goiters are seen, you might want to have that checked. However, in the U.S. and Europe, it's very difficult to develop a true iodine deficiency today, especially since most of our table salt is processed with iodine. You can actually cause or worsen thyroid problems by supplementing with too much iodine, as it is possible to take in more than your body can safely use. Most thyroid problems in the U.S. and Europe are due to autoimmune disorders or some other type of disruption in the endocrine system, rather than to an iodine deficiency.

Thyroid medication is inexpensive; it is well-studied; it solves major problems for those who truly need it; the medical profession's understanding and management of thyroid disease is improving all of the time. Likewise, the tests to deterine if you have a thyroid problem are simple. So, if you suspect a problem, why not have it tested? And, if it turns out that you do have a problem, why not pursue the treatment your body needs?

Happy home keeping!

1 comment:

Elaine said...

This is a well written post on hypothyroidism. Even though I had good medical care and live in a major city, I had to self-diagnosis my problem and ask for the testing to be done. As a middle aged woman at the time, it was implied to me that I was neurotic. My life took a serious downward spiral until I was diagnosed and the correct dosage of hormone was prescribed.
Thank you for issuing a warning.