To Your Health: Sluggish, depressed, forgetful? Could be your thyroid
BY DR. AKBAR RAHMANI Endocrinology Specialist/Ingalls Health System March 4, 2014 12:02PM
Dr. Akbar Rahmani, endocrinology specialist, Ingalls Health System, with offices in Tinley Park and Crestwood. | Supplied photo
Updated: April 6, 2014 6:09AM
Would you know it if your thyroid gland was underactive?
The symptoms can be hard to spot. But the problem is more common than you might think. More than 12 million Americans have thyroid disease, and the most common disorder related to the thyroid gland is hypothyroidism.
Women, especially those over the age of 60, are five to eight times more likely than men to have thyroid problems.
The thyroid itself is a small, butterfly-shaped gland situated at the base of the neck, just below the Adam’s apple. Hormones produced by the thyroid gland — triiodothyronine (T3) and thyroxine (T4) — have an enormous impact on your health, affecting all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate and help regulate the production of proteins.
When thyroid hormone levels are too low, the body’s processes start slowing down. As the body slows, you may notice that you feel colder, you tire more easily, your skin is getting drier, you’re becoming forgetful and depressed, and you’ve started getting constipated. Because the symptoms are so variable and nonspecific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for thyroid-stimulating hormone (TSH).
What causes hypothyroidism?
The most common cause of hypothyroidism in the United States is Hashimoto’s thyroiditis, an autoimmune disease. In some people’s bodies, the immune system that protects the body from infections can mistake thyroid gland cells and their enzymes for intruders and attack them. Unfortunately, when this happens, there aren’t enough thyroid cells and enzymes left to make a suitable amount of thyroid hormone. More common in women than men, Hashimoto’s disease can begin suddenly or develop slowly over years.
Another leading cause of hypothyroidism is surgical removal of all or part of the thyroid. Some people with thyroid nodules, thyroid cancer or Graves’ disease need to have all or part of their thyroid removed. If the entire thyroid is taken out, hypothyroidism can occur. If part of the gland is left, it may be able to make enough thyroid hormone to keep hormone levels normal.
Other causes include treatment for hyperthyroidism (too much thyroid hormone), thyroid surgery, radiation therapy to treat cancers of the head and neck, and certain medications such as lithium to treat certain psychiatric disorders.
Although anyone can develop hypothyroidism, you’re at greater risk if you’re a woman over 60; have an autoimmune disease; have a close relative (parent or grandparent) with an autoimmune disease; have been treated with anti-thyroid medications, including radioactive iodine; received radiation to your neck or upper chest; have had a partial thyroid removal surgery; and have been pregnant or delivered a baby within the past six months.
Symptoms of hypothyroidism
The signs and symptoms of hypothyroidism vary, depending on how severe the hormone deficiency is. In general, however, problems tend to develop slowly, over a number of years. At first, you may attribute tiredness and weight gain to aging. But as your metabolism continues to slow, you may develop more symptoms, including:
■ Increased sensitivity to cold
■ Dry skin
■ Unexplained weight gain
■ Puffy face
■ Muscle weakness
■ Elevated blood cholesterol level
■ Muscle aches, tenderness and stiffness
■ Pain, stiffness or swelling in your joints
■ Heavier than normal or irregular menstrual periods
■ Thinning hair
■ Slowed heart rate
■ Impaired memory
Although it seldom causes symptoms in the early stages, over time, untreated hypothyroidism can cause a number of health problems such as obesity, joint pain, infertility and heart disease.
Treatment for hypothyroidism
Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid, etc.) taken orally to restore adequate hormone levels and reverse the symptoms.
One to two weeks after starting treatment, you’ll notice that you’re feeling less fatigued. The medication also gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment continues over the course of your life, but because your dosage needs may change, your doctor will most likely check your TSH level every year.
The good news is that levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you’re still receiving the right dosage. Also, don’t skip doses or stop taking the drug because you’re feeling better. If you do, the symptoms of hypothyroidism will gradually return.
If you or someone you know is experiencing any of the symptoms of hypothyroidism, ask your primary care physician for a TSH test. If you do not have a physician to consult, call Ingalls Care Connection at (708) 915-2273.
Dr. Akbar Rahmani is an endocrinology specialist with Ingalls Health System, with offices in Tinley Park and Crestwood. Ingalls Health System is a member of the Southland Health Alliance.