Common symptoms like fatigue and weight gain may be signs of thyroid disorder

Contributing columnistDecember 14, 2013 

LEE P. THOMAS

With symptoms as common as fatigue, weight gain, anxiety, trouble sleeping and more, thyroid disorders can often go untreated.

According to the American Thyroid Association, up to 60 percent of those with thyroid disease are unaware of their condition, and more than 12 percent of the U.S. population will develop a thyroid condition during their lifetimes. Women are five to eight times more likely to experience a thyroid disorder than men.

The thyroid is a small gland in the neck that produces two important hormones — T3 and T4. These hormones control the rate of activities in the body such as how you burn calories and your heart rate — activities that make up your body's metabolism. The thyroid must produce just the right amount of hormones to keep your metabolism working properly.

The tool most often used to diagnose a thyroid disorder is a blood test that looks at the level of thyroid stimulating hormone TSH tells your thyroid to make thyroid hormones.

There are three common thyroid disorders: hyperthyroid, hypothyroid and thyroid nodules. Hyperthyroidism occurs when the body produces more thyroid hormones than needed and is most commonly treated with anti-thyroid medications that block the thyroid from making new thyroid hormones. Often symptoms begin slowly and include weight loss, eating more than usual, rapid or irregular heartbeat, anxiety, trouble sleeping, increased sweating, muscle weakness, more frequent bowel movements and less frequent menstrual periods with lighter than normal menstrual flow

Another common treatment is radioactive iodine, which is used to damage or destroy thyroid cells. In rare cases, surgical removal of the thyroid may be necessary.

Primary hypothyroidism is the opposite of hyperthyroidism and occurs when the body does not produce enough thyroid hormones. Symptoms may develop slowly and include feeling tired or sluggish, weight gain, constipation, joint or muscle pain, depression, excessive menstrual bleeding and high levels of LDL cholesterol.

Hypothyroidism is treated using medications to provide the body with the thyroid hormones it needs to function correctly.

Thyroid nodules are also a common referral for endocrinologists. A thyroid nodule is a swelling in one area of the thyroid gland. Thyroid nodules can be solid or filled with fluid or blood. There is a 5 to 10 percent chance that thyroid nodules can be malignant, or cancerous. Many nodules do not cause any problems, although some may cause obstructive symptoms or be associated with hyperthyroidism.

Once diagnosed, thyroid nodules are typically monitored via ultrasound, which can often be done in an endocrinologist's office. Ultrasound can show if a nodule is shrinking or growing. Some nodules may require a fine needle biopsy to determine whehter the nodule contains normal or cancerous cells.

If thyroid cancer is found, the cancerous nodules should be surgically removed. Sometimes, large nodules that cause problems with breathing and swallowing, but are not cancerous, may also be surgically removed or treated with radioactive iodine to shrink the nodules.

While the cause of thyroid nodules is not clear, they are quite common. Some research shows that by age 50 individuals have a 50 percent chance of developing thyroid nodules.

If you experience symptoms of any thyroid disorder, talk to your doctor about a simple TSH blood test.

Dr. Leera Patel is an endocrinologist with Saint Joseph Hospital, part of KentuckyOne Health.

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