I often get the topics for this column from people I see in my office for various conditions, and people with the same conditions show up in droves when the timing is right for the topic to be discussed. Invariably someone will come up to me at the grocery store or Wal-Mart and say thanks for the recent column on whatever the most recent topic was. Many people have mailed the column to Aunt Bessie in Mississippi who desperately needed to hear what I had to say that week or subtly laid a copy of it on their boss’s desk for a confidential hint. This week I have been urged to write about a situation that crops up for more than 6 million people in America, most of them women, and most of them over 40 – hypothyroidism.
The thyroid gland is a butterfly-shaped gland located at the base of the neck just under the Adam’s apple. It weighs about an ounce, and its major function is to produce thyroid hormones, which regulate metabolism in the body. This means it regulates the rate at which you burn calories, use fats and carbohydrates, maintain body temperature, and produce certain proteins. When it is functioning below normal levels, the thyroid gland does not produce enough thyroid hormones and the delicate balance for maintaining homeostasis, or internal stability, in your body is upset. Every organ system in the body slows down when there is not enough thyroid hormone being produced by the thyroid gland. The digestive system slows down and causes constipation, metabolism slows down and weight gain occurs, and even the brain’s functions slow down and it becomes difficult to concentrate and focus when you need to. Since everything else slows down, you of ten become tired and sluggish.
There are many different causes of hypothyroidism, but they all result in the same general set of symptoms. Common causes include autoimmune disorders, or those disorders which cause the body to attack its own organs and systems instead of fighting off infections and viruses. When an autoimmune disorder is present, antibodies which would normally fight other diseases attack the thyroid gland and affect the proper production of thyroid hormones. The most common of these disorders which affects thyroid hormone production is Hashimoto’s Thyroiditis, a condition which is characterized by chronic inflammation of and damage to the thyroid tissue. Another cause of hypothyroidism is the use of radioactive iodine. If people suffer from a condition in which the thyroid gland produces too much thyroid hormone, the most common treatment is radioactive iodine, which reduces the function of the thyroid gland. However, people are often over-treated with this substance and the thyroid gland’s function is reduced too much, causing hypothyroidism. If radiation therapy is used to treat cancers of the head and neck, often the thyroid gland is damaged and hypothyroidism results. The use of certain medications, especially lithium products, has been shown to put people at risk for an under active thyroid. Another common cause of decreased thyroid function is pregnancy. In the postpartum period, in fact, hypothyroidism is often mistaken as postpartum depression. Of course, if surgery is performed to remove the thyroid gland it will not be providing any hormones and hypothyroidism will occur.
The treatment for hypothyroidism is thyroid hormone replacement medication. The most common one is levothyroxine, which is a synthetic thyroid hormone. It might take several weeks for your body to get the appropriate level of thyroid level in your bloodstream, but it is essential for you to be sure your doctor is giving you the proper dosage of this medication. If you are given excess levothyroxine you might be at risk for osteoporosis. If you already have osteoporosis, excess levothyroxine can accelerate bone loss. Check with your doctor and express any concerns you might have about your bone density and how it is affected by your hormone replacement. There are natural alternatives to levothyroxine, but it is even harder to regulate the amount of thyroid hormone that is present in some of the over-the-counter extracts that are taken from animals. Do your homework thoroughly before you try a natural alternative. Other than the increased osteoporosis risk in the presence of too much levothyroxine, it can be used fairly safely without side effects.
As usual, be aware of your body and any specific problems you have. Your body will send signals that will alert you about any deficiencies in most cases. On a gut level, you know when things just are not as they should be. Pay attention to your body, and treat it well.