Fatigue, weight gain, impaired memory...this pretty much describes my life as a parent, but these are also signs of a potential thyroid disorder known as hypothyroidism. Nearly 1 person in every 20 over the age of 12 have hypothyroidism (that’s about 5% of the US population) and most of them are women. Given that the condition can be hard to diagnose and hard to treat, it remains an area of active research.
What Is an Underactive Thyroid?
Your thyroid is a small gland on the front of your neck in the shape of a butterfly that acts as a sort of command system for regulating how your body uses energy. So its function touches on all of our major bodily systems from digestion and reproduction to metabolism, breathing, heart rate, and mood. And when it’s not working right, all of those systems can be affected. In the case of hypothyroidism, the thyroid gland is underactive: it doesn’t produce as much of the thyroid hormones as your body needs.
Could I Have Hypothyroidism?
Rates of hypothyroidism are higher among women and people over the age of 60. Others at higher risk of developing the condition include anyone who has had a thyroid problem before or a family history of thyroid disease, those who have been pregnant in the last six months, and anyone with type 1 diabetes, rheumatoid arthritis, or lupus.
In addition to the fatigue, weight gain, and memory loss already mentioned, other signs you may have hypothyroidism include: feeling cold all the time, joint and muscle pain, constipation, dry skin, reduced sweating, hair loss, fertility problems, depression, high cholesterol, and a slowed heart rate. Since these symptoms usually develop slowly, and since they can often be indicators of other common problems like stress or lack of sleep or just regular old aging, hypothyroidism can easily be left undiagnosed for years.
This broad range of symptoms may seem unrelated but they are all connected under the thyroid’s task of using our body’s energy. For example, an underactive thyroid means a slowdown of your metabolism which can obviously lead to weight gain. But burning fewer calories can also mean you are generating less body heat and as a result, you are colder.
A slowed heart rate also means decreased blood flow which in turn means a slower replenishment of new skin cells. If your old skin cells aren’t replaced, you are left with dry, flaky skin.
The connections between an underactive thyroid and its nonphysical effects like changes in mood and cognition are less clear, but they could be a result of decreased blood flow to the brain. A lack of the necessary thyroid hormones can also affect the adrenal glands and the brain’s serotonin levels, both of which are linked to issues with depression.
What Causes Hypothyroidism?
There are several different diseases or other factors that can lead to the condition of hypothyroidism. Hypothyroidism is most commonly caused by the autoimmune disorder Hashimoto’s disease where the body’s immune system produces antibodies that attack the thyroid to the point where it cannot make enough hormones. Thyroiditis, or inflammation of the thyroid, can also cause those hormones to leak out rather than being distributed and used properly. Different forms of thyroiditis have different origins, some being autoimmune conditions, and others relating to a virus, while still others are developed postpartum.
Some babies are simply born with a thyroid that is not fully functional, known as congenital hypothyroidism, and of course anyone who has had surgery to remove or radiate part of their thyroid, perhaps as a result of cancer, are at risk of developing an underproductive thyroid.
How Is Hypothyroidism Diagnosed?
Because of all of the interwoven symptoms and risk factors, having any one of the signs or causes above does not mean you necessarily have an underactive thyroid. A proper diagnosis of hypothyroidism must take into account a full physical and family history.
A diagnosis will also include a blood test that measures the body’s level of TSH, the thyroid-stimulating hormone produced by the pituitary gland, and the levels of hormones produced by the thyroid like triiodothyronine (T3) and thyroxine (T4). If the level of TSH is adequate—in other words, the thyroid is being properly stimulated to produce hormones—but the thyroid hormone levels are low, the thyroid is likely underactive. Blood tests can also reveal unusually high levels of the thyroid-attacking antibodies produced in those with Hashimoto’s disease.
How Is Hypothyroidism Treated?
The treatment for hypothyroidism may seem simple: if the body does not produce enough thyroid hormones, fill in the gap with medicine that provides the missing hormones. And in fact, the main treatment for hypothyroidism is daily doses of the synthetic hormone levothyroxine.
But returning your body to the status quo is not always straightforward. For example, finding the right dose of the synthetic hormone can be a long dance with trial and error. Too small of a dose won’t fix the problem but too large of a dose can lead to insomnia and heart palpitations. Your ability to absorb the synthetic hormone and put it to work also depends on your diet which can thus vary over time. And unfortunately, not all cases of hypothyroidism can be treated with levothyroxine. For example, in a study of over 700 patients over the age of 65, doctors found no difference in improvement of the condition on average whether they took the synthetic hormone or not.
Your thyroid uses iodine to produce its hormones, so it may seem like a clear solution to increase the iodine in your diet by taking a supplement or, say, eating more kelp or iodized salt. However, those whose hypothyroidism is linked to an autoimmune disorder, like those with Hashimoto’s disease, may be prone to harmful side effects of increased iodine that actually worsen hypothyroidism, according to the National Institute of Health.
There is also very limited evidence that opting for a gluten-free diet can help control hypothyroidism. But that evidence is so far anecdotal and more controlled research is needed to determine whether it is really the reduction in gluten intake that improves thyroid function in these cases, and not, for example, the fiber in wheat or other lifestyle changes that commonly accompany the switch to a gluten-free diet.
There is some suggestion that rates of hypothyroidism are increasing, although that could be more of a result of an increase in our ability to properly diagnose the condition than an increase in its occurrence. The best first steps to maintaining your own thyroid health are to pay attention to the range of symptoms and related bodily systems and to understand how they are all interconnected thanks to the little butterfly-shaped gland near the front of your neck.
Until next time, this is Sabrina Stierwalt with Everyday Einstein’s Quick and Dirty Tips for helping you make sense of science. You can become a fan of Everyday Einstein on Facebook or follow me on Twitter, where I’m @QDTeinstein. If you have a question that you’d like to see on a future episode, send me an email at everydayeinstein@quickanddirtytips.com.
Image courtesy of shutterstock.
Tidak ada komentar:
Posting Komentar