WOMEN’S HEALTH Up to 60 percent of those with a thyroid disease are not aware of it.
why it may go undetected
I
BY ARCHANA PYATI
magine eating a healthy diet and exercising regularly, yet gaining weight and feeling a debilitating fatigue for no explicable reason. Now imagine going to your doctor, taking a blood test and being told you are absolutely fine. This is precisely what happened to Abbey Black, 32, a medical assistant who lives on the outskirts of Hagerstown in Falling Waters, W. Va. Seeking a specialist’s opinion can be important for women who suffer from hypothyroidism, a type of thyroid disease. It took Black a year from the “everything’s fine” conversation with her general practitioner to receiving a diagnosis from an endocrinologist that made sense to her: Hashimoto’s thyroiditis. The autoimmune disease occurs when antibodies attack the thyroid gland, impairing its ability to secrete hormones that control every major bodily function—from metabolism to heartbeat to hair growth to bowel movements. “It’s a frustrating disease,” said Black, whose mother and sisters also have Hashimoto’s. “You have to work a lot harder at things when you have thyroid disease.”
16 Gazette Health | Fall 2012
A GAZETTE PUBLICATION
The American Thyroid Association (ATA) estimates that 20 million Americans have some form of thyroid disease, and it disproportionately affects women. Women are five to eight times more likely to develop thyroid problems, and up to 60 percent of those with a thyroid disease are not aware they have a disorder. “There’s a lot of misdiagnoses,” said Majd Hakim, M.D., the Frederick-based endocrinologist who treated Black. “Many patients have symptoms for many years before they get diagnosed.” Hakim said the underdiagnoses stem, in part, from a less-than-precise blood test doctors administer to find out if a patient’s thyroid is working properly. The test measures the amount of thyroid-stimulating hormone, or TSH, in the blood. Secreted by the pituitary gland, TSH triggers the thyroid to produce essential hormones T3 (triiodothyronine) and T4 (thyroxine). The test range for what’s normal is fairly broad, which causes many patients’ thyroid disorder to remain undetected. Symptoms, like fatigue, weight gain, insomnia and depression, persist and may even be attributed to a mood disorder. “We need to look at patient family history, symptoms…a lot of times [patients] [continued on 33]
ISTOCKPHOTO: OPRAH WINFREY BY JASON MERRITT /XX, EDSTOCK CONTRIBUTOR; WOMAN AND DOCTOR, SKYNESHER
THYROID DISEASE
Sometimes a woman can experience both hyper- and hypothyroidism, as was the case with media queen Oprah Winfrey, who went public with her struggles with thyroid disease in 2009. After putting back on the pounds she had lost in the mid-2000s, she was diagnosed with hyperthyroidism, which then morphed into hypothyroidism, a culprit behind her weight gain. “Who knew this tiny butterfly gland at the base of the throat had so much power? When it’s off, the whole body feels the effects,” she wrote in her essay “How Did I Let This Happen Again?” published in O, The Oprah Magazine.