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      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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