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What You Need to Know About Thyroid Disease
By Omar Murad, M.D.
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ou may realize your thyroid gland is in your neck, but do you know how many important body functions it affects? The thyroid produces a hormone that’s essential for maintaining a good energy level, stable weight, general sense of well-being and regular sleep cycle. It also affects other functions like the digestive system, heart rate and brain function. If something’s wrong with your thyroid, the consequences can be quite serious. Hypothyroidism, the most common thyroid condition, occurs when the thyroid doesn’t produce enough thyroid hormone. It affects 3.7% of the population in the U.S, women more than men, and has a tendency to run in families. TSH screening should be part of every adult’s physical. In addition, you might ask for that test if you suffer from any of the following symptoms (more of which make the diagnosis more likely): fatigue, drowsiness, forgetfulness, dry hair and nails, dry and itchy skin, puffy face (especially around the eyes), constipation, sore muscles, unexplained weight gain, irregular cycle in women and fluid retention/swelling around the ankles. If it’s discovered you have a high TSH level (which seems counterintuitive, but means your thyroid isn’t producing enough of the hormone), the treatment
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is simple: you replace the missing hormone. In most cases, you’ll be taking a synthetic hormone pill for the rest of your life. It’s important to check your TSH level six weeks, three months and six months after starting treatment, and then annually to ensure the dosage is correct. There are no side effects to this treatment, since you’re just replacing something your body isn’t producing naturally. It is important to closely follow the dosing instructions—the pills must be taken on an empty stomach at least an hour before you eat. If you fail to treat hypothyroidism, at some point your symptoms will get worse. The only time we give patients an option to refuse treatment is when they have sub-clinical hypothyroidism, meaning their TSH level is only slightly abnormal. In those cases, we monitor closely to ensure the situation doesn’t worsen. Hyperthyroidism, as you might expect, is the opposite of its more common hypo “cousin.” This more severe condition, which occurs when your body produces too much thyroid hormone, has symptoms that include rapid heartbeat, being sweaty and hot, inexplicably losing weight, shaking in the hands, anxiety, and loose bowel movements. Treatment is more complicated for hyperthyroidism. It can include taking medication and undergoing radioactive iodine treatments, and in rare cases, surgery. Failing to treat this condition can throw your heart into an irregular rhythm, which can lead to very serious consequences, like a stroke. Thyroid nodules are another fairly common occurrence. Symptoms include a change in voice and difficulty swallowing or breathing at night, and you may even notice a nodule in the lower part of the neck.
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When a nodule is found during a routine exam, a biopsy follows. If cancer is ruled out (which occurs 95% of the time), the nodule is removed and an ultrasound is performed annually to check for re-growth. If thyroid cancer is present, it’s typically treatable, since it’s a slow-progressing disease. Most thyroid cancer patients live a normal life following treatment. If you have any questions about whether your thyroid is functioning properly, be sure to direct them to your physician. Omar Murad, M.D., a board certified endocrinologist affiliated with Sutter Medical Foundation, sees patients in Fairfield at 2720 Low Court. To request an appointment, visit suttermedicalfoundation.org or call (707) 427-4900.
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