How Do You Know if Your Thyroid is Out of Whack?
Millions of Americans experience undetected thyroid issues
The American Thyroid Association reports more than 12% of the United States
population will develop a thyroid condition during their lifetime. And
women are five times more likely to have a thyroid condition than men.
Maintaining thyroid levels is an important part of heart health, weight
management and preventing osteoporosis. We asked Nidhi Agarwal, MD, a
Torrance Memorial Physician Network practitioner who specializes in endocrinology,
to talk about symptoms, causes and treatment for thyroid disease.
What does a thyroid problem look like?
Dr. Nidhi Agarwal: Thyroid problems can be because of decreased or increased
function of the gland. Low thyroid and high thyroid are at two ends of
the spectrum. They share the common symptoms of fatigue, menstrual irregularities,
mood changes, brittle hair/nails and sleep disturbance. For hypothyroid,
which is low thyroid, someone would say, “I’m gaining weight
even though I’m not eating as much, and I feel constipated. I am
cold all the time, my skin is so dry, I’ve become so forgetful and
I’m feeling depressed.” Less often we see complaints about
a lump in the throat, causing difficulty with breathing, swallowing or speaking.
The other end of the spectrum, with high thyroid or hyperthyroidism, people
usually rapidly lose weight despite having a good appetite. They feel
anxious or irritable, hot and sweaty so their palms are almost moist.
The heart rate is high, and they sometimes can feel it beating hard in
their chest. Some also complain of loose stools and difficulty sleeping
at night. Regardless of the type of disease, these are some of the common
thyroid symptoms to look for.
What causes thyroid issues?
NA: The most common cause of hypothyroidism is autoimmunity, where the
immune system makes antibodies that can attack the thyroid gland. It can
run in the family but can happen suddenly as well. In other cases, surgical
removal, iodine deficiency, radiation exposure or medications can affect
the function of the thyroid. Hyperthyroidism can be caused by stimulating
antibodies known as Graves’ disease, or nodules in the gland which
cause increased hormone secretion or can happen transiently with a viral
infection of the thyroid.
Does age affect the likelihood of developing a thyroid condition?
NA: As we age, normally our thyroid function tends to slow down and the
normal reference ranges increase. However, thyroid disorders have no age
limits. Hypothyroidism is more common in elderly than in young adults
and is often underdiagnosed. Unlike younger people, older people may not
have all the symptoms on the thyroid spectrum but can have significant
change in their quality of life with just one or two symptoms. Regardless,
we as physicians have to be very vigilant in making a diagnosis, as once
diagnosed most patients require long-term follow-up. Thyroid function
measurement is done with an easy blood test, and the results should be
interpreted by an experienced physician keeping the patient’s symptoms
in context.
What treatment is available for thyroid disease?
NA: Medication is the most common treatment for hypothyroidism. It does
not cure the condition but only controls it. Usually we first try thyroxine
(T4) therapy, since it has a good response, minimal side effects and the
dose is easy to adjust. There are other preparations of synthetic liothyronine
(T3) and combination therapy of T4+T3 available as Armour Thyroid and
Nature-Throid, which are less commonly used. The treatment for high thyroid
depends on the cause, but our options include medications, surgery and
the use of radioactive iodine I-131 to destroy the thyroid gland.
What steps should someone take if they think they have a thyroid condition?
NA: Persons with a family history of thyroid disease, personal exposure
to radiation/neck surgery and taking medications like amiodarone/lithium/interferons
should be mindful of their symptoms. They should either see their primary
care physician or an endocrinologist and discuss their symptoms in detail.
If they have had any previous tests done on the thyroid, it would be helpful
to bring those to the visit. Screening for thyroid problems is done with
a thyroid stimulating hormone (TSH) level, which can be obtained at any
time of the day with a blood draw and can help direct further need for testing.
Nidhi Agarwal, MD, is an endocrinologist with the Torrance Memorial Physician
Network. Her office is located at 2841 Lomita Blvd., Suite 320, in Torrance.
She can be reached at 310-517-8952.
Endocrinology Services at Torrance Memorial Physician Network
Torrance Memorial Physician Network’s endocrinology office recently
moved to a larger suite and added two endocrinologists to its team. Patients
will benefit from a specialized practice with five physicians who treat
conditions including adrenal disorders, diabetes, osteoporosis, pituitary
diseases and thyroid conditions. The office provides treatments, therapies
and services that include assessment for hormone deficiencies and excess
syndromes, insulin pump therapy, nutrition counseling, testing for adrenal
tumors and ultrasound of thyroid. The most common health problem endocrinologists
treat today is diabetes—it affects 1 in 10 adults in California.
Torrance Memorial Physician Network provides a wide range of treatment
options that include diabetes education and management programs.