Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, April 4, 1995 TAG: 9504050018
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: JANE BRODY
DATELINE: LENGTH: Medium
If the condition is diagnosed and properly treated, affected individuals can lead normal, active lives. But the millions who are unaware of their condition may be experiencing subtle and slowly worsening symptoms that are progressively debilitating but easily overlooked or mistaken for a host of other conditions, including the normal effects of aging or hypochondria. Among other things, untreated hypothyroidism, as an underactive thyroid is called, can raise the risk of heart disease by causing high blood pressure and elevated cholesterol levels.
Hypothyroidism is five to eight times as common in women as in men, and experts say that as many as one in 10 elderly women suffer from it. In younger women, untreated hypothyroidism can result in infertility, miscarriage or difficulty in carrying a pregnancy to term. In newborns, it is the cause of a rare condition called cretinism, whose symptoms are stunted growth and mental retardation.
Thyroid hormones are perhaps best known for the control they exert over the rate of metabolism - how fast food is broken down and converted into chemical energy. Those with a slow metabolic rate - one consequence of a thyroid insufficiency - often complain that they gain weight merely from looking at food.
The most common cause of an underactive thyroid in older women is an inherited condition called Hashimoto's thyroiditis, an autoimmune disorder in which the body produces antibodies that attack and gradually deactivate the gland. Certain medications, including lithium and some asthma drugs, and radiation treatments for cancers that occur in the neck area can also result in a thyroid insufficiency.
Although a lack of dietary iodine was once a common cause (iodine is needed to produce the hormones), the use of iodized salt and a nationally distributed food supply that includes iodine-rich foods has essentially eliminated this cause.
Hypothyroidism can also result from the treatment of hyperthyroidism, an overactive thyroid. Since the treatment often eventually knocks out the hormone-producing tissue, sooner or later those with hyperactive thyroids will become hypothyroid and need to take replacement hormones.
Are you feeling tired or lethargic? Are you having trouble remembering things or concentrating on tasks? Is your skin becoming dry and coarse? Is your hair thinning? Have you been depressed? Do you suffer from constipation? Are you gaining weight even though you seem to be eating less than usual? Are you becoming increasingly sensitive to the cold? Have your nails become brittle, your menstrual periods irregular, your voice hoarse?
Any or all of these symptoms could be a sign of hypothyroidism, an insufficient production of thyroxine (T4) and triiodothyronine (T3). These are the two hormones produced by the thyroid, a small, two-lobed gland in your neck that is shaped like a butterfly. Even if you do not as yet have any recognizable symptoms, you could have an underactive thyroid gland that can result in organ damage if the problem is not diagnosed and treated with replacement hormone.
Hypothyroidism is perhaps the quintessential masquerader. At first it produces no recognizable symptoms, and when symptoms start to become noticeable, they tend to be vague and seemingly unrelated to one another. And since the condition most commonly affects women and develops in midlife, it is easily mistaken for signs of aging or the consequences of menopause.
As a result, many people with hypothyroidism never think to see a doctor about their symptoms. And those who do consult a doctor are sometimes told that nothing seems to be wrong with them, suggesting that their complaints are psychosomatic rather than caused by a physical ailment.
There is now available a very simple and sensitive blood test - the TSH assay - for detecting abnormal thyroid activity long before symptoms are obvious. Adults, especially older women, would be wise to request a thyroid test periodically, for example, whenever undergoing a routine physical. Also strongly recommended is a thyroid test for all newborn babies and for women with a history of infertility or miscarriage. Since thyroid problems tend to run in families, anyone with a family history of hypothyroidism should also be tested from time to time.
An excellent source of information on all manner of thyroid problems is ``The Thyroid Sourcebook'' by M. Sara Rosenthal (Lowell House, 1993, $23.95).
Jane Brody is a syndicated health columnist and author.
by CNB