Why Is Hypothyroidism So Under Diagnosed In The Usa
Many symptoms of thyroid imbalance are vague and most doctors spend only a few minutes talking with patients to sort out the cause of their complaint.
Most conventional doctors use only one or two tests to screen for problems. They are not checking FT3, RT3 or thyroid antibodies.
Most conventional doctors use the normal lab reference range as their guide only. Rather than listening to their patients symptoms, they use optimal lab values and temperature as their guide.
If Your Loved One Has Thyroid Cancer
If your loved one has thyroid cancer, they have an entirely different challenge. The majority of thyroid cancers are considered highly treatable and survivable, so doctors and others often cavalierly refer to thyroid cancer as “the good cancer.” But the reality is, no cancer is “good,” and someone who has thyroid cancer has cancer, “the big C.” Cancer as a concept is frightening and raises fears and concerns.
Someone with thyroid cancer initially may have few, if any, symptoms. In some cases, however, they may have hypothyroid, hyperthyroid, or mixed thyroid symptoms.
Most thyroid cancer patients require surgery to remove the thyroid. This surgery can feel daunting, including the idea of a several-inch incision in the neck and resulting visible scar. After surgery, many thyroid cancer patients will need to have follow-up radioactive iodine treatment to ensure that all the cancerous tissue was removed, and it can be many weeks after surgery before a thyroid cancer patient, who by that point is typically quite hypothyroid, can start thyroid medication to again get lifesaving thyroid hormone.
What Are The Symptoms Of Postpartum Thyroiditis
When the thyroid becomes inflamed, it first sends a lot of thyroid hormone into your blood. That causes hyperthyroidism. During this time, you may not have any symptoms. Or any symptoms you do have may be mild and not last long.
After this first phase, you may fully recover. Or your thyroid may be damaged. A damaged thyroid can become underactive. This condition may also go away. Or you may have an underactive thyroid for the rest of your life. In this case you may need hormone replacement.
Each persons symptoms may vary. Symptoms may include:
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Favorite Sites For Hypothyroid Diet Advice
Its often said that food is just as important as medicine, and this couldnt be truer when youre dealing with symptoms of hypothyroidism including any extra weight you cant seem to get rid of. Still, the internet can often cause more confusion when youre trying to figure out what you can and cant eat with hypothyroidism. We find the above article helpful in debunking some of the myths about diet and hypothyroidism, while also providing sound medical advice on what you should be eating.
For a less technical read, Endocrine Web offers a succinct overview on the right foods to eat with a thyroid condition. We find the advice about not falling for fad or elimination diets a big relief, as well as the rule of thumb to focus on eating more vegetables, and not avoiding them for fear of decreased thyroid function.
What To Consider In Your Personal And Family Medical Histories
Its important to give your physician as many details as possible about your personal medical history, as well as family history . Be sure to discuss:
- Your general state of healthparticularly any changes you have noticed in your general overall health.
- Your familys health historyespecially if a close relative has been diagnosed with hypothyroidism .
- Whether youve ever had thyroid surgery, or radiation to your neck to treat cancer.
- Any medicines you may be taking that could cause hypothyroidism .
Physical ExaminationLooking for Signs of HypothyroidismYour physician will perform a thorough examination and look for physical signs of hypothyroidism, including:
- Evidence of dry skin
- Swelling around the eyes and legs
- Slower reflexes
- Slower heart rate
Blood Tests: Hypothyroidism can be detected by different blood tests.
- TSH Test. A thyroid-stimulating hormone or TSH is a blood test that measures the amount of T4 that the thyroid is being signaled to make. If you have an abnormally high level of TSH, it could mean you have hypothyroidism.
- T4 Test. The thyroid gland produces T4 . The free T4 and the free T4 index are blood tests that, in combination with a TSH test, can let your physician know how your thyroid is functioning.
Normal and Abnormal TSH Ranges
An easy way to remember how the thyroid works–think about supply and demand. As the T4 level falls, the TSH rises. As the T4 level rises, the TSH falls. However, not everyone with hypothyroidism has elevated levels of TSH.
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Questions To Ask Your Doctor
- What is the cause of my hyperthyroidism?
- Do I have Graves disease?
- What types of food and medicine contain high levels of iodine?
- What is the best treatment?
- Will I need to take medicine? If so, for how long and what are the side effects?
- Will I need surgery? If so, what are the benefits and risks?
- Are there any lifestyle changes I can make to relieve my symptoms?
- Am I at risk for related health problems?
Seek Treatment Based On Thyroid Function Status Not Perceptions
Patients should also know that the TSH levels that are on listed on websites as normal or abnormal may refer only to specific age ranges. There is a wide difference between what is acceptable for a 30-year-old than for a 60-year-old. While 2.5 mlU/L is a great level for the former, 6 mIU/L is fine for the latter, Dr. Hennessy adds.
Age is only one of the factors that I rely on in evaluating whether or not a patient would benefit from thyroid replacement therapy, says Deena Adimoolam, MD, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
We need to assess the patient based on her overall clinical situation history of symptoms, physical examination, comorbidities, other medsand lab values, specifically thyroid function tests, keeping in mind that these tests, specifically the TSH, will change with age in making a determination to treat or not to treat.
While you might feel certain that you have hypothyroidism and insist that your doctor give you levothyroxine , according to Dr. Hennessey, physicians must resist these entreaties and instead should offer you alternatives to address your concerns.
Should you experience a change your health status, such as taking new or different medications or doses, experiencing new life circumstances, such as pregnancy, these may warrant a fresh evaluation of your thyroid function levels, Dr. Adimoolam says.
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Diagnosis Of An Underactive Thyroid Function Is Made Based On A Combination Of Thyroid Blood Test Results Symptoms And Several Other Factors
Hypothyroidism is evaluated and diagnosed by a physician, usually an endocrinologist or your primary care doctor. Symptoms, signs, and more critically, blood testsare taken into consideration when evaluating the possibility of an underactive thyroid glandall of which help identify the cause and severity of the disease.
A diagnosis is reached after a thorough review of the patients personal medical and family histories, any risk factors, findings on physical examination, in addition to the results of thyroid function levels. There are several types of hormones checked in a blood test to assess your thyroid statusthe most definitive one is the TSH . Often, physicians may decide to check the free thyroxine, or T4, free T4 index, or total T4 to aid in the diagnosis.
Your doctor may check your thyroid status for an underactive thyroid by reviewing thyroid hormone levels. Photo: 123rf
Favorite Orgs For Essential Hypothyroidism Symptoms Info
As leading professionals on all things endocrinology, the physicians and experts from the Endocrine Society offer the latest research and 101 information on hypothyroidism. The Hormone Health Networks overview of hypothyroidism in particular is required reading for the latter, as its overview page offers key intel on how to spot signs of hypothyroidism and receive a prompt diagnosis.
Established in 1913, the American Thyroid Association is one of the oldest-serving organizations dedicated to thyroid health and research. Such extensive expertise informs their page on hypothyroidism, which not only discusses short-term symptoms, but also what you can expect with this condition down the road. Also be sure to check out the ATAs subpages on specific hypothyroid concerns, such as their Thyroid and Weight page, as weight changes are a key concern for people with this thyroid disease.
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What Causes An Overactive Thyroid Gland
The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the bodys growth and metabolism. These hormones are called thyroxine and triiodothyronine.
They affect processes such as heart rate and body temperature, and help convert food into energy to keep the body going.
In hyperthyroidism, the thyroid gland produces too much thyroxine or triiodothyronine, which speeds up the bodys metabolism.
There are several possible underlying causes, the most common being Graves disease, in which the bodys immune system targets the thyroid gland and causes it to produce too much of the thyroid hormones.
Reasons Why People Get Thyroid Problems And How To Avoid Them
The thyroid gland, shaped like a butterfly, sits quietly in the front region of your neck. Despite its somewhat odd choice of residence, this gland is essential for producing hormones, many of which will affect your overall metabolic rate and your efforts at the gym. If it doesnt function well, youll shortly notice the signs of thyroid problems.
Thyroid issues are surprisingly common, affecting more than 20 million people in America alone. But what do you need to know about it?
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What Is A Goiter
A goiter is an unusually enlarged thyroid gland. It may happen only for a short time and may go away on its own without treatment. Or it could be a symptom of another thyroid disease that requires treatment. goiter is more common in women than in men and especially in women before menopause.
Some common causes of goiter include:
Usually, the only symptom of a goiter is a swelling in your neck. It may be large enough that you can see it or feel the lump with your hand. A very large goiter can also cause a tight feeling in your throat, coughing, or problems swallowing or breathing.
Your doctor will do to see if it is caused by another thyroid disease.
Plus How To Get The Absolute Most Out Of Your Thyroid Meds
The time of day you take your thyroid meds, and how you store them, can make or break your thyroid disease management.
Levothyroxine is the name of all synthetic forms of the thyroid hormone T4. This manufactured hormone mimics the natural hormone produced by your thyroid and is prescribed as the primary treatment for hypothyroidism, or an underactive thyroid.
Levothyroxine dosage is highly individualized, and your dosage may change as you and your doctor work to find what works best for you. See our levothyroxine dosage chart below to get an idea of where your treatment might begin and when to expect your doctor to check for adjustments. Starting dosages are often calculated based on your weight, but because in some cases your thyroid still makes its own T4, some doctors will start you with a lower dosage to avoid over-treatment symptoms that mimic hyperthyroidism . They also may start you on a lower dose if your body might need extra time to adjust to the effects of hormone replacement. Your doctor will then check your thyroid stimulating hormone levels over the first few months to see if your dosage needs any adjustment. Hormone replacement therapy is usually a lifelong treatment, so you should get your TSH levels checked every year to ensure youre still taking the right dose.
Infographic by Lauren Hunter
You can find more information about levothyroxine, including dosage, here.
- Increased sweating
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What Does The Thyroid Do
Your thyroid has an important job to do within your body releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your bodys systems working correctly. Think of your metabolism as a generator. It takes in raw energy and uses it to power something bigger.
The thyroid controls your metabolism with a few specific hormones T4 and T3 . These two hormones are created by the thyroid and they tell the bodys cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.
This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone . The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.
Signs You Might Have A Thyroid Problem
When your thyroid stops working as it should, you can experience a variety of symptoms that might seem unrelated or even odd. From chills and brain fog to thinning hair and weight gain, if your thyroid isnt functioning well, you may be experiencing symptoms that are subtle and hard to characterize.
Women are more likely to experience issues with their thyroid, but anyone can suffer thyroid problems. Recognizing the symptoms of an overactive or underactive thyroid is the best way to get the treatment you need.
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Who Is At Risk For Thyroid Cancer
About three times as many women get thyroid cancer as men. The number of women with thyroid cancer is also going up. By 2020, the number of women with thyroid cancer is expected to double, from 34,000 women to more than 70,000 women.
Thyroid cancer is more common in women who:
- Are between the ages of 25 and 65
- Had radiation therapy to the head or neck, especially in childhood, to treat cancer
- Have a history of
- Have a family history of thyroid cancer
How To Treat Thyroid Problems
Now that you know more about the problems that indicate thyroid problems, what should you do? Of course, the first thing you should do is ask your doctor about your symptoms. Depending on your symptoms, you may have another condition that needs to be treated.
However, if you are experiencing several of these symptoms at a time, you most likely have a thyroid condition.
Before you start receiving treatments, first youll need to work with your doctor to get tested. Typically this will include blood tests to check the levels of T4 and T3 in your blood. When the tests come back, your doctor will help you know that to do next.
Usually, treatments include hormone replacement therapy. Iodine supplements may be prescribed in order to treat goiters.
However, if your symptoms are severe, it can be a sign of thyroid cancer. In which case youll need to visit a thyroid surgeon to remove the cancerous cells. Chemotherapy and radiation oncology are also viable options.
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Signs And Symptoms Of Thyroid Problems
Symptoms of thyroid problems aren’t always obvious. In fact, the ATA estimates that up to six in 10 people with thyroid problems do not know they have them. Both hypothyroidism and hyperthyroidism can cause feelings most people have from time to time, such as mood swings or tiredness, so how can you tell the difference between an everyday symptom and something that needs treatment? Check in with your body often, and if any of the following signs persist, talk to your physician.
Hypothyroidism Is The Most Common Thyroid Disorder
The thyroid does a lot for your body. It makes hormones that keep organs running properly. It also controls the way you use energy: for example, how you burn calories and how fast your heart beats.
But sometimes this powerful gland doesn’t work like it’s supposed to.
One common thyroid condition, called hyperthyroidism, causes the thyroid to make more hormones than the body needs.
But the most common thyroid disorder is hypothyroidism, which affects about 4.6% of people in the U.S. This condition causes a lack of hormone, which leads the thyroid to slow down. People with hypothyroidism often gain weight and feel tired, but some may not have any symptoms at all.
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Who Is More Likely To Develop Hyperthyroidism
Women are 2 to 10 times more likely than men to develop hyperthyroidism.2 You are more likely to have hyperthyroidism if you
- have a family history of thyroid disease
- have other health problems, including
- pernicious anemia, a condition caused by a vitamin B12 deficiency
- primary adrenal insufficiency, a hormonal disorder
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