Wednesday, January 20, 2010

What's Up with Your Thyroid?

Not to be a total downer, but January is Thyroid Awareness Month. FREEZE! Back away from the mouse. This is important stuff. I wish, wish, wish someone had told me 20 years ago what I’m about to tell you. Just bear with me, and I’ll try not to make this as dry as last week’s meatloaf.

Full disclosure here: I’m not even an expert on my own thyroid, much less yours, but awareness is what we’re shooting for this month, because there are many people with undiagnosed thyroid conditions who are suffering needlessly.

So, what is it? The thyroid is a small butterfly-shaped gland located in the lower part of the front of the neck.

What does it do? The thyroid’s main job is to produce thyroid hormone, which act as tiny little messengers telling different body parts what to do. Thyroid hormones assist in making energy, regulating your weight, temperature and emotions, among other things.

It is a sad fact that millions of people have undiagnosed thyroid conditions and diseases. So, if you have never had a thyroid work-up or it’s been a while, GET ONE! No need to panic, because this doesn’t involve tubes up the wa-hoo or any other invasion of your private tidbits. Basic screening for thyroid problems is nothing more than a clinical evaluation performed by your doctor or other healthcare professional and simple blood tests.

Also, screening for thyroid problems on a fairly regular basis is important whether you are having any of the symptoms of thyroid dysfunction or not. (See below) I had none of the typical symptoms when I was diagnosed, and my thyroid was sputtering worse than the ’62 VW bug I had in high school. If not for a super sharp nurse practitioner who had the sense to order a complete thyroid panel at an annual poke and gouge session, I have no doubt things would have gotten pretty ugly pretty fast.

And, I cannot stress this enough, thyroid issues do not discriminate. They can occur at any age and, while they seem to affect women more often than men, men can also have them.

I know some doctors routinely order basic thyroid testing at annual physicals, but most do not. It is your body and your health, so don’t be afraid to say you want this testing done. Women, in particular, tend to get told they are stressed or depressed and are not taken seriously. Given that the thyroid directly impacts emotions and weight, which women tend to struggle with more than men, I guess we shouldn’t be surprised that doctors tend to dismiss our symptoms. Our best line of defense it to become armed and dangerous with knowledge and learn to stand up for ourselves.

Personally, I can’t count the number of times, even after I was diagnosed with hypothyroidism and Hashimoto’s, that my doctors did not listen to me and just wanted to give me a prescription for anti-anxiety or anti-depressant meds, when I knew darned good and well it was my whacked-out thyroid. If they try to blow you off, be polite but firm. I have found this usually works, although I have had to fire a couple of doctors for being stupid-heads. Bottom line, if your doctor will not listen to you, FIND ANOTHER ONE. Actually, when my former doctor asked if anything was stressing me out, I said, “Yes! YOU are!” What can I say? Some days I’m more Southern Belle and some days I’m more Steel Magnolia . . . Notice I say he is my “former” doctor.

Anyway, with all that in mind, I want to do my part to stamp out thyroid ignorance and give a very BASIC overview of the most common thyroid conditions and diseases, because there is a very good chance you or someone you know has a dysfunctional thyroid. And, since the thyroid is a command center for the body, it demands a lot more respect than most people, including some doctors, give it.

Thyroid conditions:

Hypothyroidism: When the thyroid gland is not producing enough thyroid hormone, it is said to be underactive. List of risk factors and symptoms:

Hyperthyroidism: When the thyroid gland is producing too much thyroid hormone, it is said to be overactive. List of risk factors and symptoms:

Autoimmune thyroid diseases – NOT to be confused with immune deficiency diseases

Hashimoto’s: Antibodies form which attack and destroy the thyroid and disrupt and slow its function. Basically, your immune system has somehow (no one understands how) taken a wrong turn at Albuquerque and sees your thyroid as something bad, like an invading bacteria. It is possible to have Hashimoto’s and not be hypothyroid (underactive thyroid). In my case, I had a goiter (an enlarged thyroid) for 15 years before I was diagnosed with Hashimoto’s and hypothyroidism. I believe I had undiagnosed Hashimoto’s for years and eventually my thyroid was destroyed to the point where it was not producing enough thyroid hormones, and I developed hypothyroidism.

Some doctors believe treating Hashimoto’s with thyroid hormones, even when they test within the so-called normal range, can slow down or stop the progression of Hashimoto’s. If I had been diagnosed with Hashimoto’s and treated early on, it is possible I would never have developed hypothyroidism and my thyroid would be in much better shape now. Too late for me, but maybe it’s not for you. Just sayin’ . . .

More info on Hashimoto’s:

Graves Disease: The immune system attacks the thyroid and overstimulates it, causing symptoms of hyperthyroidism. Symptoms and additional info:

So, on to testing:
Here is a list of what the clinical evaluation should include and a list of blood tests:

Now, don’t get overwhelmed here, because the list of thyroid blood tests is quite lengthy. Tests should be ordered based on the results of the clinical evaluation and any symptoms you may be having. Generally, the basics are ordered including: TSH, Free T4 and Free T3.

IMPORTANT NOTE: Currently, there is some controversy among doctors about the appropriate “normal” range of Thyroid Stimulating Hormone a/k/a TSH. Even though, as of 2003, the American Association of Clinical Endocrinologists recommended the normal range for TSH run from 0.3 to 3.0, some doctors and labs are still using the older range of 0.5 to 5.5. According to the new standards, levels above 3.0 are evidence of possible hypothyroidism, and levels below 0.3 are evidence of possible hyperthyroidism.

If you have an enlarged thyroid, known as a goiter, I would insist on the Thyroid Peroxidase (TPO) Antibodies testing. Like I said before, if this test had been performed when my goiter was first discovered, it is possible I could have been treated and been spared a lot of grief later.

If, for some mysterious reason, your doctor will not order a thyroid panel or, if you simply prefer to order your own, there are resources: (Please review your results with a healthcare professional.)

Personally, I hit the trifecta (or is that thyfecta?) of thyroid dysfunction - I have hypothyroidism, Hashimoto’s, and a multi-nodular goiter. A multi-nodular goiter is quite common with Hashimoto’s. The last ultrasound of my thyroid more closely resembled a lump of Play-Doh someone walked on with cleats, rather than the serene little butterfly it’s supposed to look like.

Finally, remember you are more than a lab number. Ideally, your doctor will be just as interested, if not more so, in whatever symptoms you are having than your test numbers. I have been extremely lucky to have found a doctor who not only listens to me, but gives me credit for having two brain cells that fire simultaneously. Whenever I see him, he always asks me first how I am feeling, and he looks directly at me and listens to what I say. Not once has he told me it was all in my head or I was just stressed out or “Well, you know, you ARE getting older.” Don’t you hate that one? We have worked together to determine the appropriate treatments and medications that work for me, and I trust him. As a result, I am feeling better now than I have in years. He has truly been an answer to a prayer. And, yes, I have told him that.

So, don’t be scared. Get tested! Please.

For more information on these and other thyroid issues, forums, and tremendous support (which has saved my sanity more than once), check out these sites:

Wishing you Happy Thyroid Trails!


Gypsy Trading Company said...

WOW, Have to say, (not to be weird or nothing) loving you more and more. I have "fired" so many doctors, I lost count, and still going. Interestingly enough, I have found one at a small town clinic that caters to the poor, (lack of insurance now) and she does what I need. I do not have thyroid issues, mine is a rare immune disease, but the same principal applies. I did my own research and ended up with better results than the experts. Great Post!

An Aside, I will send my GF's daughter in law here. She was just diagnosed with graves, and is flipping out. They call me, and I advise, with links and patience, but you have wonderful information also.

Thanks for another great post!

Sara A Broers said...

Wow~Awesome post. As a two time thyroid cancer survivor, let me tell you, you hit it all right on the head! GREAT POST! Thanks for posting a great awareness post. It is frustrating when a Dr. won't listen or insurance won't help out.........Ugghhh...the list goes on and on.

Anonymous said...

Actually, the ultrasound of advanced Hashimoto's looks like Swiss cheese

Patricia Wilson said...

I am 21 years old. My mother passed away 5 years ago. I increased 50 pounds without eating. I thought it was severe depression since I hit my teens. After repeatedly getting sick and fainting. I was diagnosed with hypothyroid. I have been on natural thyroid medication for about 2 months and I can feel the symptoms decreasing each week.

Brenda said...

Thank you Brenda so very much for putting this up. This information is desperately needed !! I,myself suffer with this condition, recognised n found by my family doctor while in my 30's. I, Stupid me didn't take it seriously for years. It is a condition to be completely concerned about n to be made aware of. It is far more important than most people know and left untreated can be very dangerous. Even many doctors have it on the bottom of their list. And unless it's mentioned to the doctor,your condition can go untreated. And be given treatment for other conditions you don't have. I had/have more than one condition / illness, so it made my situation more confusing / complicated n crazy. PLEASE get Check ??? Sincerely,