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Talking to Your Doctor About Thyroid Disorders—Commentary

18/01/17 Jerome M. Hershman, MD, MS, David Geffen School of Medicine at UCLA|West Los Angeles VA Medical Center and Endocrine Center, UCLA;

Resolutions to get healthy in the new year should go beyond losing weight and eating better. Staying on top of regular screenings and check-ups plays an important role in your overall health. Because January is Thyroid Awareness Month it’s fitting to discuss thyroid problems. If you’re not familiar with the bow-tie shaped gland just below your Adam’s apple, the start of 2017 is the perfect time to have a conversation with your doctor and learn more about thyroid screenings.

It’s definitely worth paying attention to your thyroid. More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime, but according to the American Thyroid Association as many as 60 percent of people with a thyroid disease are unaware of it. That’s likely because most of the symptoms associated with thyroid issues are non-specific, meaning they do not point to a specific disease or condition. Although things like fatigue, weight gain, and dry skin could be signs of an underactive thyroid gland, plenty of other conditions claim these as symptoms. This can make it difficult for physicians to tell whether you have a thyroid disorder – unless they do some tests.

Two common thyroid dysfunctions

The thyroid gland is critical because it produces hormones that control the body’s metabolism. Thyroid hormones (called T3 and T4) impact a host of vital body functions, including heart rate, skin maintenance, growth, temperature regulation, fertility, and digestion.

If your thyroid gland produces too much or too little of these essential hormones, you may develop a serious disorder.

Hypothyroidism is underactivity of the thyroid gland, slowing vital body functions. Common symptoms of hypothyroidism include weight gain, constipation, feeling cold, puffy eyes and face, hoarse and slowed speech, and coarse, dry hair and skin. Nearly five out of every 100 Americans over the age of 12 have hypothyroidism, and it’s much more common in women and people older than 60.

A less common condition is hyperthyroidism, which is an overactive thyroid gland. Symptoms of hyperthyroidism may include increased heart rate and blood pressure, feeling warm and sweaty, nervousness and anxiety, diarrhea, difficulty sleeping, and weight loss.

Who is susceptible to thyroid problems? 

Women are particularly at risk for a thyroid issue. One in eight women will develop a thyroid disorder during the course of their lives—that’s five to eight times the rate in men.

If thyroid issues run in your family, you may be at greater risk of developing hypothyroidism.

Who needs thyroid testing?

First of all, if you’re experiencing symptoms, check with your doctor. If your symptoms seem like they could be due to a thyroid disorder, the doctor will likely order blood tests.

Even if you’re not experiencing symptoms, some doctors recommend regular screening for hypothyroidism for certain people (doctors don’t screen for hyperthyroidism because its symptoms are usually more obvious). Hypothyroidism screening is done through a blood test that measures the level of thyroid-stimulating hormone (TSH) in your blood. TSH is the hormone that tells the thyroid to produce thyroid hormones. A high TSH level usually means your thyroid gland isn’t producing enough hormones.

Doctors and professional groups have different recommendations on who should have screenings. One group does not feel screening is helpful. Other groups recommend screening but differ on who should be screened. Taking it all into account, balancing the modest cost and inconvenience of a blood test with the potential benefit of finding hypothyroidism early, many doctors think it is reasonable for the following people to consider getting screening tests of their thyroid gland:

  • Women who are age 35 or older
  • Men who are 65 or older
  • Women who are pregnant, especially pregnant women who have a family history of thyroid issues, or type 1 diabetes or who are extremely overweight, or older than 30

Doctors do agree that all newborn babies should have screening for congenital hypothyroidism.

The bottom line

If you suspect you are experiencing symptoms related to your thyroid gland, talk to your primary care physician right away. Detection is the key to getting the condition under control and getting you on your way to a healthier year to come.

If you are not having symptoms, at your next check-up consider having a discussion with your doctor about whether thyroid testing is reasonable for you.