Screening for thyroid disease

October 11, 1998|By Marian Uhlman | Marian Uhlman,KNIGHT RIDDER/TRIBUNE

Another screening test has been added to the recommended list for women over 50: one to check whether the thyroid gland is working properly.

The newly merged American College of Physicians and American Society of Internal Medicine recently developed the new screening guidelines. The thyroid gland produces hormones that help control metabolism. Too little hormone can make people appear sluggish, depressed and forgetful. They can feel chilly and gain weight. Too much hormone can make them nervous, heat-intolerant and prone to weight loss.

The symptoms of thyroid disease can be masked in older women because they resemble signs of aging. The medical group says a simple blood test can help detect the disease.

Among women over 50 - considered most at risk - one out of 71 has symptomatic thyroid disease that should be treated.

In all, 11 million Americans have hypothyroidism, in which the gland produces too little thyroid hormone. Less common is hyperthyroidism - when the gland makes excessive hormone. It affects about 2 million Americans, mostly women between 20 and 40.

Hypothyroidism can be easily treated with a daily pill containing synthetic thyroid hormone. Hyperthyroidism is often treated with radioactive iodine, surgery or pills that block hormone formation.

The screening involves a blood test to check the level of a pituitary hormone called thyroid-stimulating hormone (TSH). The pituitary hormone is responsible for regulating the thyroid gland. If the test shows that the pituitary gland is pumping out too much hormone, it indicates the thyroid gland is not producing enough of its own hormone.

If the initial test suggests the thyroid gland may be out of whack, a follow-up blood test will be ordered.

THE FACTS

* About 13 million Americans have a thyroid disorder, yet more than half remain undiagnosed.

* If left untreated, thyroid disorders can lead to serious, long-term effects such as heart disease, osteoporosis and infertility.

* Women are five to eight times more likely than men to suffer from an overactive or underactive thyroid.

* About one out of eight women will develop a thyroid disorder during her lifetime.

SIGNS AND SYMPTOMS

Hypothyroidism - an underactive thyroid gland - can cause:

* Fatigue

* Weakness

* Depression

* Memory loss

* Unusual menstrual cycle

* Hair loss

* Slow heart rate

* Weight gain

* Puffy hands, face and/or eyelids

* Intolerance to cold temperatures; little or no sweating.

Usual treatment method: Synthetic hormone pill, levothyroxine sodium, which restores normal blood levels of thyroid hormone.

Hyperthyroidism - an overactive thyroid gland - can cause:

* Sleep disturbances

* Muscle weakness/tremors

* Irritability

* Enlarged thyroid (goiter)

* Unusual menstrual cycle

* Hair loss

* Irregular heart rate

* Weight loss

* Vision problems or eye irritation

* Heat intolerance; feeling perpetually warm, constant sweating.

Usual treatment methods: Drugs that block hormone production; radioactive iodine treatment to disable the overactive thyroid; removal of all or part of the gland.

SOURCE: American Medical Women's Association

INFORMATION

* American Medical Women's Association: P.O. Box 1854, Radio City Station, New York, N.Y. 10019, or on the Web at http://www.glandcentral.com

* Kelly G. Ripken Program, Johns Hopkins resource for thyroid education and patient care: 410-614-1174 or 1-888-595-2131 or at http://thyroid-ripken.med.jhu.edu

* Thyroid Foundation of America: 1-800-832-8321, or at http://www.tsh.org

INFORMATION

For more information, contact the Thyroid Foundation of America, Ruth Sleeper Hall-RSL 350, 40 Parkman St., Boston, Mass., 02114-2698; telephone 800-832-8321. The foundation offers doctor referrals and information on treatments.

Pub Date: 10/11/98

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