Thyroid Disease Symptoms May Mimic Other Problems

Wednesday, September 22, 2004

Are you feeling tired or tense? Have you been losing or gaining weight? Maybe it’s stress—or maybe you have thyroid disease.

The thyroid gland, located in the lower part of the neck, is one of the endocrine glands. The thyroid produces hormones that are needed for normal body metabolism. It plays an important role in your health and affects every organ, tissue, and cell in your body. When the thyroid is not working properly, it can affect a person’s weight, energy level, muscle strength, skin, menstrual cycle, memory, and heart rate.

Although thyroid disease is fairly common, the range of symptoms associated with it can be mistaken for other health problems. Feeling tired and chilly can mean your thyroid is underactive, but these could also be due to other causes. Feeling tense and overworked could mean you have an overactive thyroid, or just plain stress. Thyroid disease may be overlooked in a pre-menopausal woman who may have similar symptoms. That’s why your doctor needs to do the proper tests.

Types of Thyroid Disease
The most common thyroid diseases are an overactive gland (hyperthyroidism or Grave’s disease) or underactive gland (hypothyroidism). Hyerthyroidism affects roughly 5 to 8 percent of the population, while hypothyroidism is even more common.

  • With an overactive thyroid gland, too much thyroid hormone is produced. Symptoms include fatigue, weight loss, nervousness, rapid heart beat, increased sweating, feeling hot when others don’t, changes in menstrual periods, more frequent bowel movements, tremors.

  • An underactive gland does not produce enough thyroid hormome. Symptoms include fatigue or weakness, weight gain, decreased appetite, change in menstrual periods, loss of sex drive, feeling cold when others don’t constipation, muscle aches, puffiness around the eyes, brittle nails, and hair loss. If the gland becomes inflamed (thyroiditis), it can result in a goiter or enlarged gland. Being female, over 40 years of age, having a close family member with thyroid disease, and recently having a baby are factors that can increase the chance of getting hypothyroidism.

  • Another type of thyroid problem is the development of nodules or lumps in the gland. They may appear gradually or very rapidly. Patients who had radiation therapy to the head or neck as children are more prone to develop thyroid malignancy. While most thyroid nodules are benign (not cancerous), a doctor should evaluate all thyroid nodules. If a lump in your thyroid is diagnosed, your doctor may recommend a biopsy.

Most people with thyroid disease have some, but not all of these symptoms.

Diagnosing Thyroid Disease
Thyroid disease is diagnosed by your symptoms, an exam, medical history, and tests. Tests may include a blood test, an ultrasound exam (during pregnancy), a thyroid scan, a biopsy (for a lump), and other tests.

Blood testing can determine the adequacy of the levels of thyroid hormones to determine if the thyroid gland’s hormone production is normal, overactive, or underactive. It’s recommended that all adults, beginning at age 35, have a baseline thyroid blood screening with follow-up testing every five years.

Women have a much higher risk for thyroid disease than men. A woman faces as high as a one in five chance of developing thyroid problems during her lifetime, a risk that increases with age and for those with a family history of thyroid problems.

Your risks of having thyroid disease are higher if:

  • Family members have thyroid or other immune-system problems (e.g., insulin-dependent diabetes, rheumatoid arthritis, colitis, pernicious anemia).
  • You are pregnant or a new mother.
  • You are a woman over 50 or a man over 60.
  • You’ve been exposed to radiation through therapy or other means.

If a person has been diagnosed with Grave’s disease (hyperthyroidism), smoking will make the symptoms worse.

Treatment
Thyroid disease can be treated with medication alone or with surgery, radioactive iodine, or a combination of these treatments.

  • An underactive thyroid is treated with thyroid replacement therapy (medication).
  • An overactive thyroid is treated with medication that blocks the formation and release of thyroid hormone. Another option is radioactive iodine treatment, which destroys the overactive thyroid tissue.
  • For a thyroid nodule, treatment will depend on test results. Most nodules are benign, and may be treated with thyroid hormone to attempt to shrink them. If a nodule continues to grow during treatment, it may be necessary to remove it surgically.

If you think you may have a thyroid problem, see your physician. If you have ever had a thyroid disorder, it is important to have your thyroid levels checked on a regular basis.


Dr. Archana Bindra is an endocrinologist on staff at Columbia St. Mary’s. She practices at Internal Medicine Specialties, S.C., 414-276-1906
 

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