[Anonymous]

#1039569

I came across this article sent to me by a friend
and had it cleared by NGDF-Administration before posting.
I am sure as you read this you will see yourself in the article.
 
Undiagnosed thyroid problems affect millions of Americans
Monday, March 13, 2000
By ABIGAIL LEICHMAN
and PATTY SHILLINGTON
About 18 months after giving birth to her third child, Ellen began to
worry that she was going through early menopause, even though she was
only in her 30s.
At night, she had hot flashes and sweats. By day, she walked around in
short sleeves in the winter. She felt an undercurrent of anxiety most of
the time.
When the Teaneck resident explained these symptoms to her
obstetrician-gynecologist, the doctor ordered a simple blood test that
revealed Ellen’s problem was an overactive thyroid gland, or
hyperthyroidism.
In the 10 years since her diagnosis, Ellen, who asked that her last name
not be used, has found that she is one of about 13 million Americans —
most of them women — who have a disorder of the thyroid, a small,
butterfly-shaped gland in the neck between the Adam’s apple and
collarbone.
Thyroid dysfunctions are autoimmune disorders in which the body attacks
the gland, leading the thyroid to produce too little or too much
hormone. The cause is unknown, though thyroid disorders tend to be
hereditary.
The American Association of Endocrinologists believes half the cases of
thyroid dysfunction remain undiagnosed. But as evidence mounts that
thyroid disorders can lead to serious problems — including high
cholesterol, heart disease, stroke, infertility, osteoporosis, and
depression — the medical group is urging physicians to make thyroid
screenings routine for every new patient, and especially for women over
40.
“I have done more screenings in the past three to four years because we
are finding a lot more thyroid disease,” said Dr. Susan Volpicella-Levy,
a family practitioner in River Vale. “Finding it before the patient is
symptomatic is best, because we can start treatment before it causes
serious complications.”
Those with thyroid dysfunction are most likely to have an underactive
thyroid, or hypothyroidism. That means the gland isn’t producing enough
hormone for the body’s energy needs.
Miami Beach family physician Armando Solis diagnoses an underactive
thyroid “about once a month.”
“That’s a lot,” said Solis, an assistant clinical professor at the
University of Miami Medical School and medical director of UM Care Miami
Beach, a clinic. “Everybody that’s a new patient here, all females, are
screened for hypothyroid. I’ve picked up a lot of asymptomatic people.
When the thyroid is starting to become underactive, you don’t have a lot
of obvious symptoms. Maybe some sluggishness. They don’t link that to
having an underactive thyroid.”
Although the symptoms, such as fatigue, are often vague, hypothyroidism
causes the metabolism to slow down and results in complications that can
include the buildup of cholesterol in the bloodstream.
Yet a recent survey of people with high cholesterol found a large
majority were unaware of the gland’s impact on cholesterol regulation,
and fewer than half knew whether they had ever been screened for thyroid
disorder.
“It happens slowly; for 10 years your cholesterol is slowly but surely
going up. We need to heighten awareness of thyroid disease to catch it
early and treat it early,” said Dr. Stanley Feld, a Dallas
endocrinologist and past president of the endocrinologists’ group.
Synthetic hormone replacement, taken as a daily pill, is commonly used
to treat hypothyroidism.
Hyperthyroidism — which causes more obvious symptoms, including a
racing heart rate, vision problems, and loss of hair — occurs when the
thyroid makes too much hormone. The most common form is Grave’s disease,
which is what Ellen had.
Dr. Peter Hannoush, a Hackensack endocrinologist, said treatment options
for Grave’s disease include anti-thyroid medication, radioactive iodine,
or surgery to remove all or part of the gland.
Ellen’s endocrinologist in New York initially put her on medication. But
within a few years, the pills were no longer effective and even caused
her to feel lethargic because they were overcorrecting her problem.
Ellen chose radioactive iodine treatment over what she felt was the more
risky alternative of surgery.
“First, the doctor did tests to see how large the gland was and how much
iodine to give,” said Ellen. “I just swallowed a pill, then had to stay
away from small children for about 24 hours and be careful to use paper
plates and so on. But you don’t glow in the dark,” she said with a
laugh.
Now that her thyroid gland is inactive, Ellen takes a daily dose of
Synthroid, a synthetic thyroid hormone, which must be adjusted
periodically if she starts feeling symptoms of either hyper- or
hypothyroidism.
Despite her ordeal, she said she feels fortunate. “My father’s mother
probably died of complications of thyroidism because treatments then
were severe — they cut out the thyroid and didn’t know how to measure
how much to cut,” she said. “So she developed heart problems.”
Today, the precision of both diagnosis and treatment is far better, said
Dr. Leroy Strom, an Englewood endocrinologist. “Thyroid disease has been
underdiagnosed in the past, but in the last five years the screening
test has become very sensitive and easy to do,” Strom said.
“The majority of physicians don’t overlook thyroid any more than they do
osteoporosis,” which can be exacerbated by an overactive thyroid. “More
sensitive tests are available to monitor the effectiveness of the
treatment, which wasn’t always good because it upset the balance and
caused overtreatment.”
That’s what happened to Bergen County resident Zoe, an author in her 40s
who asked that her real name not be used.
Zoe had been treated briefly for hyperthyroidism 25 years ago, but until
July the disease had stopped causing symptoms. So when she started
feeling a racing heartbeat again, she knew right away what it was.
“I went to an endocrinologist, and the numbers were extremely high,” Zoe
said. Like Ellen, she opted for radioactive iodine treatment. But the
resulting hypothyroidism caused extreme sleepiness and proved difficult
to manage. She is in the midst of having the dosage of synthetic hormone
fine-tuned. “It can take months to get it right,” she said.
Ellen now realizes she probably had a thyroid condition for a long time.
“I had mood swings for years,” she said, “and was told to go see a
psychiatrist.”
The two women recommend the Web site http://www.thyroid.about.com, which offers
up-to-date information as well as chat rooms. Ellen also cautions those
who suspect they have a thyroid problem to seek a specialized
endocrinologist and to always have periodic testing performed at the
same lab.
“Different labs can calibrate their equipment differently, so results
can also come out differently,” she said.
* * *
Special from The Miami Herald
Underactive:
Symptoms of an underactive thyroid — hypothyroidism — can be subtle or
confused with symptoms of other disorders. They include:
Fatigue, drowsiness, lack of energy.
Weight gain.
Depression.
Sensitivity to temperature, feeling hot or cold very easily.
Slow heart rate (fewer than 60 beats a minute).
Elevated blood pressure.
Constipation.
Poor memory, difficulty concentrating.
Puffy face, thinning hair.
Dry, coarse, or flaky skin.
Heavy menstrual flow, infertility.
Goiter (swelling in the neck).
Overactive:
Symptoms of an overactive thyroid — hyperthyroidism, which is much less
common — are more obvious and include:
Racing heart rate.
Nervousness, irritability.
Insomnia.
Weight loss.
Tremors.
Frequent bowel movements.
Increased sweating.
Source: American Association of Endocrinologists
* * *
For more information, visit the American Association of Clinical
Endocrinologists’ Web site at http://www.aace.com
Abigail Leichman is a Record staff writer. Patty Shillington writes for
The Miami Herald.
Copyright © 2000 Bergen Record Corp.
 
 
 
 
 
 
 
 

 

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