The lowdown on thyroid slowdown
Midlife can bring subtle changes in our skin, hair, energy, weight,
and even mental outlook. Before writing them off as products of aging,
it’s a good idea to make sure they’re not the result of
an underactive thyroid. This tiny butterfly-shaped gland influences
virtually every organ system in the body. The hormones it secretes
into the bloodstream play a vital role in regulating metabolism — the
rate at which our bodies convert food and oxygen to energy. Low thyroid
hormone production, or hypothyroidism, causes a range of symptoms— fatigue,
constipation, dry skin and brittle nails, aches and pains, and feeling
down — that you might easily attribute to other health problems.
Hypothyroidism is especially common in women. Between ages 35 and 65,
about 13% of women will have it, and the proportion rises to 20% among
those over 65. Because the link between symptoms and thyroid disease
isn’t always obvious many women won’t know they have it — and
won’t be treated for it.
Untreated hypothyroidism can increase your risk for high cholesterol,
high blood pressure, and heart disease. Hypothyroidism can be diagnosed
with a blood test and treated with a pill.
The symptoms of hypothyroidism can differ from person to person and
can come on gradually or abruptly.
Characteristic signs of hypothyroidism include:
- Fatigue. Low thyroid function can result in less energy.
- Cold intolerance. Slowed-down cells burn less energy, so the body
produces less heat.
- Appetite loss, weight gain. With lower energy needs, you require
fewer calories, so your appetite declines. Yet, your body converts
fewer calories into energy, so you may gain a few pounds.
- Cardiovascular effects. Low levels of thyroid hormone can lead to
high blood pressure, elevated levels of cholesterol, and increased
homocysteine (a risk factor for heart disease). The heart’s pumping
ability may slow increasing the risk of congestive heart failure, especially
in older women.
- Mental effects. Hypothyroidism and depression share many of the same
symptoms, including difficulty in concentrating, memory problems, and
loss of interest in things that are normally important to you. They
call for different treatments, so proper diagnosis is important.
- Other signs and symptoms. Slowed metabolism reduces sweating, so
the skin may become dry and flaky and nails brittle. Hair may thin
or become coarse. Digestive processes slow, causing constipation. Speech
and movement may also slow down. In younger women, periods may become
heavier and more frequent, or they may stop; infertility is sometimes
a problem. Muscle aches and pain around the joints are common. Older
women may have balance problems.
If you have any symptoms, see your clinician for a physical exam. You’ll
be checked for signs of hypothyroidism, such as an enlarged thyroid gland,
dry skin, hair loss, weight gain, and elevated cholesterol levels. Your
clinician may test your blood for levels of thyroid-stimulating hormone
(TSH) — the single best screening test for thyroid disease — as
well as the thyroid hormone thyroxine (T4).
Treating low thyroid
Hypothyroidism is usually treated with a daily dose of synthetic T4
(levothyroxine sodium), in pill form. Levothyroxine works exactly like
your own body’s thyroid hormone. The goal of drug treatment is
to lower your TSH to about the midpoint of normal range and maintain
it at that level. Typically, you’ll start with a relatively low
dose and have your TSH checked six to eight weeks later. If necessary,
your physician will adjust the dose, repeating this process until your
TSH is in the normal range. Once the right dose is established, your
TSH and possibly T4 levels will be checked every six months to a year.
Most people who take enough synthetic T4 to normalize TSH levels will
find that their symptoms go away.
January 2006 Update
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