Northwest Health Fall 2012

Conquering Illness

Symptoms Could Mean Thyroid Trouble

No energy? Nervous? Sleeping poorly? Gaining or losing weight?

Go to: Northwest Health Index

Gunjan Tykodi, MD, a Group Health Physicians endocrinologist, sometimes feels more like a detective than a doctor. Many of the patients she sees have troubling symptoms — unexplained weight gain or loss, a lack of energy, general fatigue, depression, forgetfulness, nervousness, poor sleep, eye problems — that could have any number of causes.  At best, these symptoms are irritating.  At worst, they interfere with quality of life or are incapacitating.

It's Dr. Tykodi's job to tease out the root cause of these varied symptoms. Sometimes, that cause involves a malfunctioning thyroid gland.

A Common Problem

According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime, and many are unaware of the condition, in part because of the varied nature of its symptoms.

Thyroid problems are much more common in women than men: One in eight women will develop a thyroid problem in her lifetime. There are a number of theories about why, but no overwhelming scientific consensus.

"The thyroid, a butterfly-shaped organ that sits in the neck just below the voice box, regulates our metabolism and how our bodies use and store energy," says Dr. Tykodi. That means when things go wrong, many problems can occur, she says. If undiagnosed and untreated, thyroid disease can put sufferers at risk for major medical problems like heart disease, osteoporosis, infertility, or miscarriage.

Diagnosis and Disorders

Many thyroid problems can be diagnosed with a simple blood test, but taking a health history is often key to the correct diagnosis, Dr. Tykodi says. "Family history plays a large role." That is, you are more likely to develop thyroid problems if it runs in your family.

There are two common afflictions of the thyroid. The most frequent is hypothyroidism, where the gland doesn't produce enough thyroid hormone. Symptoms include fatigue, depression, forgetfulness, and sometimes weight gain, Dr. Tykodi says. It responds very well to medication containing replacement hormone.

The other condition is hyperthyroidism in which the gland makes too much thyroid hormone. Symptoms include irritability or nervousness, sleep problems, weakness, weight loss, and eye problems. Graves' disease falls into this category. It can run in families, and is an autoimmune disorder like lupus or type 1 diabetes. It's usually treated short-term with anti-thyroid medication and long-term with radioactive iodine. This destroys the thyroid and cures the hyperthyroidism but often leads to hypothyroidism. When this happens, thyroid hormone medication is needed to replace the missing hormones, Dr. Tykodi says.

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