Dr. Kelly Shanahan: Blood tests can diagnose hypothyroidism
April 1, 2014
Are you feeling tired, sluggish, cold? While it might be the lovely spring weather we've been having lately, it also could be an underactive thyroid.
Hypothyroidisim, a condition where the butterfly shaped thyroid gland located in front of the Adam's apple does not produce enough hormones, affects approximately 5 percent of all Americans. Women are much more likely than men to have the condition and the incidence increases with age.
The thyroid gland makes two hormones: triiodothyronine (T3) and thyroxine (T4) under the command of thyroid stimulating hormone (TSH) which is produced in the pituitary gland in the brain. The thyroid hormones affect brain development early in life, as well as playing a major role in metabolism and weight, regulation of the cardiovascular and respiratory systems, nervous system function, body temperature, and cholesterol levels. Thyroid hormones also influence reproductive hormones and an imbalance in them can lead to menstrual irregularities and infertility.
Symptoms of hypothyroidism can vary from person to person and may include fatigue; weight gain; intolerance to the cold; dry skin; constipation; thin, dry hair; depression; puffiness or fluid retention. Sometimes, as the thyroid gland struggles to make enough T3 and T4, a goiter develops. A goiter is a swelling of all or part of the thyroid gland and may be visible, or may lead to a sensation of fullness in the neck or throat or difficulty swallowing.
Hypothyroidism can be easily diagnosed by checking levels of TSH in the blood. When the thyroid gland does not make enough thyroid hormones (T3 and T4), the pituitary gland in the brain spits out more TSH. I liken it to yelling at your kids to put the trash out — first you ask nicely, then louder and louder when you're ignored the first 5 times (no, this never happens in my house!). A high TSH means an underactive thyroid.
The treatment for hypothyroidism is to replace what Mother Nature and your thyroid gland aren't making, usually by prescribing a synthetic version of T4. Synthroid is the most common brand name, but many people get generic levothyroxine. Natural thyroid hormones like Armour Thyroid are also available and contain a mix of T4 and T3, derived from dried pig thyroid glands. While some endocrinologist (specialists in hormone producing organs like the thyroid) are opposed to using such products due to concerns about contamination and variation of dose, some patients do better on this formulation.
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If you think you may have hypothyroidism your doctor can order the appropriate blood tests and, if your thyroid gland indeed is not functioning properly, prescribe the appropriate medication. It is very important that your thyroid function be monitored closely, with a blood test 2-3 months after starting medication or any dosage change. Once stable, blood tests need only be done yearly. Once you are receiving adequate replacement, energy levels should return to normal, and you should feel up to enjoying our soon to come good weather!
Dr Kelly Shanahan is a board certified gynecologist and the owner of Emerald Bay Center for Women's Health. This month marks her 20th year practicing in SLT. Call 530-542-4961 for an appointment.