Thyroid: On the level
Tara Vandegrift can empathize with patients who complain of overwhelming fatigue and even depression.
Vandegrift, a doctor at Palmetto Primary Care Physicians, has hypothyroidism, a condition whose symptoms often are difficult to distinguish from a host of other problems.
“Hypothyroidism is underactivity of the thyroid gland, a butterfly-shaped gland found in the neck,” says Dr. Lou Luttrell, director of the Division of Endocrinology, Diabetes and Medical Genetics at the Medical University of South Carolina. “Thyroid hormone is an important regulator of the entire body’s metabolic rate. All of the cells of your body are sensitive to the thyroid hormone.”
And when the thyroid gland is underactive, everything can feel just a little off kilter.
Sandra Gaylord of Charleston first experienced symptoms of hypothyroidism when she was about 48. Instead of the onset of hot flashes she was anticipating with the approach of menopause, Gaylord got sweeping waves of bone-chilling cold.
“It’s one of those things you can’t really know, it isn’t an ache or anything,” she says. “Everywhere I went for a year, I nearly froze to death. It was the kind of cold that was painful. I was so cold, it hurt.”
When she also began to feel depressed, Gaylord sought help. A blood test determined that she had hypothyroidism. With treatment, Gaylord has improved dramatically.
“I’ve done great,” she says.
About the disease
Luttrell says hypothyroidism is relativity common, affecting about 10 million people. Even more than that probably have abnormal thyroid hormone levels, but they aren’t affected by the abnormality, Luttrell says.
“Thyroid conditions are far and away more common, at least five to 10 times more prevalent, in women than in men,” he says. “Younger patients, typically women, most often have Hashimoto’s thyroiditis (an autoimmune disease). In older adults, it’s usually an enlarged thyroid gland (goiter).”
Hypothyroidism can be diagnosed with a simple blood test. The test measures levels of the thyroid stimulating hormone, a substance made by the pituitary gland that stimulates the thyroid, Luttrell says. Elevated TSH is associated with hypothyroidism.
If hypothyroidism is diagnosed, treatment is relatively simple, though it can take six to eight weeks before the levels even out, Luttrell says.
“Treating hypothyroidism amounts to taking one small tablet once a day,” he says.
Vandegrift says she probably sees a patient every day who is treated for hypothyroidism, but only a few are young mothers.
“It’s really more prevalent in women over the age of 50,” she says. “A lot of moms do come in, and a lot of times I am diagnosing them with new motherhood. With a baby, you will be tired. Your body just doesn’t function right without sleep.”
However, younger women do sometimes develop thyroid problems following pregnancy, Vandegrift says.
“The problem with hypothyroidism is that the symptoms are extremely nonspecific: weight gain, tiredness, lethargy, fatigue, brittle hair, puffiness, blood pressure and cholesterol tend to run a little higher,” Luttrell says. “Those symptoms are easily confused with other things, most commonly the stress of everyday life. When it is severe, the symptoms can be profound.”
Whether their fatigue is due to a lack of sleep or hypothyroidism, young women with symptoms should contact their doctor.
“Pregnancy can induce a type of hypothyroidism,” Vandegrift says. “It can’t be discounted as a reason for the fatigue. It’s a blood test, and we can pretty quickly rule it in or out.”
Luttrell says women who are being treated for hypothyroidism should tell their doctor if they are contemplating pregnancy.
“If you have a young woman who is hypothyroid and on thyroid replacement who gets pregnant, she needs to get to her doctor right away,” he says. “Demand for thyroid hormone can go up 30 (percent) to 50 percent in pregnancy. Hypothyroidism in pregnancy is associated with increased risk of miscarriage. They really should, at the first OB appointment, make sure their thyroid level is checked.”