You have gained weight, although you haven’t changed your typical eating habits – or you are dieting but the weight is not coming off.
Your skin is drier than usual, although you are moisturizing regularly.
You feel anxious and don’t know why, although you are not a generally anxious person.
You have lost weight, although you haven’t changed your typical eating habits.
If yes, take our one-question, super-easy, very enlightening quiz!
QUESTION: Do you bother telling your doctor about any of the symptoms mentioned above?
ANSWERS (choose one):
A) No, of course not. It’s annoying, but I’m so busy with work and family – no wonder I feel tired. I should splurge on a spa day and a nice moisturizer. B) My doctor will just give me pamphlets on how to sleep better and how to lose weight. C) No, it sounds silly and is probably nothing. Anyway, my doctor examines me and takes blood, and tells me if there is a problem. D) Yes, definitely. (This is the correct answer. Smile if you got it right!) My doctor will probably add thyroid function tests to my routine blood tests. This will let us know if I have a thyroid condition that is manageable, but if left untreated, can become very dangerous. Besides, once it is treated, I will feel much better.
Keep reading for an explanation of common thyroid conditions and why it is so important to tell your doctor about symptoms that may seem unimportant to you!
What is a thyroid condition? Actually, what is a thyroid?
The thyroid is a gland located in the front of the neck, just below the Adam’s apple. Your thyroid secretes two hormones, called T3 and T4, into the bloodstream in response to direction from another hormone called thyroid stimulating hormone (TSH). These two hormones, T3 and T4, directly affect the speed of your metabolism, in other words, all of the biochemical processes taking place in the body. As shown by the illustration below, if your thyroid is not releasing enough T3 or T4 hormones your bodily functions will feel slower than usual. If your thyroid is releasing too much T3 or T4 your bodily functions will feel faster than usual.
Common symptoms of…
Certain thyroid diseases can be present for years without causing symptoms. When symptoms do occur, they can be vague (such as weight gain, difficulty sleeping, anxiety, or constipation) and are not obviously the result of a disease process. Thyroid diseases affect virtually every part of the body, and we have listed here only a limited number of symptoms. While rare, if not properly treated, producing too little thyroid hormone can eventually lead to a life-threatening condition called myxedema coma, and producing too much thyroid hormone can lead to a life-threatening condition called thyroid storm.
What causes hypothyroidism or hyperthyroidism? Does this have something to do with Hashimoto’s or Graves’ diseases?
Having hypothyroidism or hyperthyroidism can result from having had thyroid surgery or prior thyroid disease or treatment; having been exposed to radiation around the head, neck, or upper chest; taking certain medicines; eating foods containing too little or too much iodine; producing too little/too much TSH; or having Hashimoto’s or Graves’ disease. In fact, the #1 cause of non-iodine related thyroid disease is Hashimoto’s disease, which causes hypothyroidism.
Hashimoto’s disease, and Graves’ disease – which is a leading cause of hyperthyroidism – are both autoimmune diseases. In an autoimmune disease our immune system, which normally produces antibodies intended to attack invaders such as viruses and harmful bacteria, instead produces antibodies which attack the body’s own cells. In Hashimoto’s, the immune system attacks and destroys thyroid cells, resulting in progressive underproduction of T3 and T4, and causing hypothyroidism. In Graves’ disease, the immune system makes antibodies disguised as TSH. These antibodies cause the thyroid to release too much T3 and T4, leading to hyperthyroidism.
How does someone get Hashimoto’s or Graves’? Can I prevent it from happening to me?
Currently, there are no recommendations available to help prevent Hashimoto’s or Graves’. We know that some people are genetically more likely to develop an autoimmune thyroid disease, and that race does not appear to play a role. Certain triggers have been identified in those who are genetically susceptible, but we do not know how to prevent Hashimoto’s or Graves’ from developing once triggered. We do know, however, that certain factors make people more likely to be diagnosed with these diseases. These risk factors include:
Ok, I’ve read enough. I think I might have a thyroid condition. What can I do about it?
First, make an appointment to see your doctor. Describe your symptoms, state that you are concerned that you might have a thyroid problem and request that your blood be tested. Your doctor will ask other questions and examine you. Keep in mind that your doctor will also be considering other possible causes of your symptoms, and may recommend tests to look for or rule out other conditions. Ask your doctor when you can expect the results, and if you do not hear anything by that time, call to follow up. Never assume that because you have not gotten a phone call, nothing is wrong. Lab tests can get lost, doctors can get busy with work or have a personal emergency, and phone numbers can be incorrectly dialed.
What if it turns out I have Hashimoto’s?
While no one wants to be diagnosed with a disease, try to consider that you are fortunate to have been diagnosed – whether it is before you have developed symptoms, or if symptoms have already begun. With medicine you can look forward to an improved quality of life, with more energy and fewer symptoms.
Typically, treatment for Hashimoto’s consists of taking an oral medicine whose generic name is Levothyroxine Sodium. If your doctor prescribes a brand rather than the generic, the name will be different but the medicine is the same. Levothyroxine is simply a man-made version of the thyroid hormone the body produces. Since your body is no longer producing enough of this hormone, you will have to take the medicine for the rest of your life.
So I just have to take a pill every day? That seems easy enough.
Well, it is somewhat easy, but not completely easy. The trick to taking Levothyroxine, as with any medicine, is taking it exactly as your doctor recommends. Levothyroxine must be taken with a glass of water on a completely empty stomach, at least 30 minutes prior to eating. Most people find that it is most convenient to take first thing in the morning, before getting dressed and eating breakfast.
It is also important to avoid certain foods and other medicines both four hours before and four hours after taking Levothyroxine. Eating those foods can dramatically change how much of the medicine is actually available for your body to use. Your doctor will give you a list, which will most likely include walnuts, grapefruit juice, cottonseed meal, hi-fiber foods, and possibly soy.
Medicines to be avoided for four hours before or after taking Levothyroxine include many antacids (those containing calcium, magnesium or aluminum), Iron supplements/ multivitamins with iron, and certain medicines for heartburn, high cholesterol and a few other conditions. It is extremely important that you tell your doctor about every medicine or supplement that you take. Very often an alternative can be found, but only if your doctor knows what you take.
Levothyroxine will not start to work immediately. It may take several weeks before you notice an improvement in symptoms – but it will work. Do not give up and stop taking it. Equally important – even though you may feel fine once it begins to work, you must keep taking it consistently, at the same time every day.
Store Levothyroxine at room temperature, away from humidity or heat. The bathroom is generally not a good place to store medicine. Keeping it next to your alarm clock, with a glass of water nearby, can be a good reminder to take it first thing. Drugs.com is an excellent website for further information on Levothyroxine and other medications.
But I’m pregnant or planning a pregnancy. Isn’t medicine dangerous for the baby?
If you are pregnant, it is absolutely critical that you take this medicine. If you have even a hint of a symptom of thyroid disease, make an appointment to see your doctor as soon as possible. Even mild hypothyroidism, if untreated, can lead to severe complications for both you and the baby, including birth defects, miscarriage, prematurity or stillbirth. Levothyroxine is safe to take while breastfeeding. If you are already taking it, your doctor will most likely adjust your dose to meet your body’s needs during pregnancy and breastfeeding.
If you are planning a pregnancy, it is important for both you and the baby that you begin the pregnancy with a healthy body and balanced levels of thyroid hormones. Also, untreated hypothyroidism can reduce fertility, making it less likely that you will conceive.
What if it turns out that I have Graves disease?
Graves’ disease is treated differently than Hashimoto’s disease. There are various methods of treatment, including prescribing anti-thyroid medications, giving radioactive iodine or surgery. The goal of treatment is to control over-production of thyroid hormones. Your doctor will discuss options for treatment with you.
Radioactive iodine absolutely cannot be given to anyone who is pregnant, so it is extremely important to tell your doctor if you are pregnant or planning to conceive in the near term. The next time you are chatting with your friends and they mention one of the symptoms listed, you will know exactly what to tell them. Please spread the word about thyroid disease – who knows, you might save a life!
Jill Sabin Garner received her Bachelor of Science in Nursing (summa cum laude) from New York University. A Registered Nurse and Certified Diabetes Educator, she serves on the boards of both the New York State Coordinating Body and the Metropolitan New York Group of the American Association of Diabetes Educators.