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What's Up Magazine

The Butterfly Effect

Mar 07, 2014 10:44AM ● By Cate Reynolds
by KATHLEEN JEPSEN

You’ve gained weight. Your hair is thinning, and your skin is dry. Your memory is fuzzy, and you have trouble sleeping at night. Not surprisingly, you are depressed. If you think that these symptoms are the inevitable signs of aging, think again.

All these and many more may actually be the result of the malfunction of a small, butterfly-shaped, endocrine gland in the neck called the thyroid. The thyroid is our regulator of metabolism, brain development, body temperature, and the nervous system. A malfunctioning thyroid can cause serious issues with blood pressure, heart rate, cholesterol levels, even menstrual cycles and fertility.

Fundamental thyroid function is dependent on the pituitary gland in the brain, which regulates the release of TSH, thyroidstimulating hormones. They act upon the thyroid gland to produce thyroxine (T4) and triiodothyronine (T3). T3 is far more active than T4, and is the hormone responsible for increasing metabolism. This is a complicated process, and the disruption of T4 or the inhibition of T4 to T3 conversion may prevent our bodies from maintaining optimum metabolism, growth, and energy.

If you are female, you are more at risk. According to Georgetown University Medical Center:
  •  An estimated 20 million Americans have thyroid disorders
  •  Approximately 1 in 8 women will develop thyroid problems in her lifetime
  •  Women are 5 to 8 times more likely than men to suffer thyroid issues
  •  By age 60, as many as 17 percent of women have an underactive thyroid
  •  5 to 8 percent of women develop thyroid abnormalities after giving birth

Among the most prevalent thyroid issues is hypothyroidism, caused by underactive hormone production. According to the Mayo Clinic, hypothyroidism “seldom causes symptoms in the early stages, but, over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, and heart disease.” Hypothyroidism can present with a variety of symptoms, including fatigue, weight gain, insomnia, depression, constipation, cold hands and feet, hair loss, and psychiatric issues. Hashimoto’s Thyroiditis, an autoimmune condition in which the body’s immune system attacks its own cells, is the most common cause of hypothyroidism in the United States. Women are 15–20 times more likely than men to develop Hashimoto’s. Other triggers for hypothyroidism might be aging, alcohol consumption, diabetes, chemical exposure, radiation, iodine over-exposure, and stress.

Another major thyroid issue is hyperthyroidism, overactive thyroid hormone production. In this case, according to the American Thyroid Association, “every function of the body tends to speed up.” Among the symptoms the Association lists are nervousness, irritability, hand tremors, anxiety, thinning hair and skin, racing heart, fatigue, vision problems, and weight loss. The most common cause of hyperthyroidism is Graves’ disease, a hereditary condition that is five times more common in women than in men. Other triggers include stress, smoking, thyroid nodules (goiter), and excessive thyroid medicating.

Most general practice physicians are capable of addressing basic thyroid malfunction. But in the event that nodules are present, or when cancer, autoimmune-related Hashimoto’s disease or Graves’ disease is suspected, experts advise consulting an endocrinologist, who specializes in hormonal issues like thyroid disease. The standard diagnostic tool for thyroid disease is a TSH blood test to detect suspiciously high or low levels of T3 or T4 (with .4 to 5 as a baseline). However, there is controversy among the medical community as to whether TSH testing alone is an adequate gauge, as well as what actually constitutes a “normal” range.

Treatments for thyroid issues are as varied as the patients who need them. They depend on the type and severity of the thyroid malfunction, as well as the age, general health, and preference of the patient. The most prescribed therapy for hypothyroidism is a synthetic hormone, levrothyroxine, and continued monitoring of symptoms and TSH levels. In the case of hyperthyroidism, antithyroid drugs, radioactive iodine therapy, or surgery (rare) are among the choices. Recently, gluten intolerance has been implicated in thyroid disease, with celiac patients four times more likely to develop an autoimmune thyroid condition. Some physicians may, therefore, suggest that patients eliminate gluten from their diets.

Recent reports indicate an increase in thyroid disease, including thyroid cancer (which, according to the American Cancer Society, is three times more prevalent in women). Experts disagree as to the cause of this rise, but environmental exposure, diet, and the surge in autoimmune disease are likely culprits.

On the positive side, women, in whom the butterfly gland seems particularly vulnerable, are asking more questions. Rather than accepting the debilitating symptoms of a hypoactive or hyperactive thyroid as a natural part of aging, women are seeking the answers they deserve and the treatments they need.