The effects of an
By Heidi Smith Luedtke
THE THYROID GLAND plays a powerful
role in your health. This butterfly-shaped
structure in the neck releases hormones
affecting energy metabolism, body temperature and mood. Nearly 5 percent of Americans
have hypothyroidism, which occurs when the
thyroid gland fails to make enough thyroid
hormones. Without adequate thyroid hormones, you’re likely to feel sluggish and
depressed. You may also gain weight and suffer from dry skin and hair loss.
TSH measurements alone, but Taylor says
that can be misleading. Specialists evaluate
TSH and FT4 values in the context of your
medical history and a complete exam, because
test results can be affected by other hormones,
such as estrogen, and conditions such as liver
or kidney disease.
Because thyroid symptoms are nonspecific, they may be misattributed to other causes.
The American Thyroid Association recommends routine thyroid screening at age 35 and
every five years thereafter. This requires blood
tests and a consultation with your doctor.
More frequent screening may be warranted if you have a family history of thyroid
disease or if you have antibodies associated
with Hashimoto’s disease, an autoimmune disorder in which the body attacks its own thyroid
cells, says Costco member Cathy Doria-Medina, M.D., endocrinologist at Healthcare
Partners in Torrance, California. Patients with
subclinical levels of hypothyroidism should be
retested annually, because the risk of thyroid
disorders increases with age.
The gold-standard assessment includes
measuring thyroid stimulating hormone
(TSH) and the amount of T4 thyroid hormone that is “free” to enter your cells (FT4),
says Costco member Amber Taylor, M.D.,
endocrinologist and director of the Diabetes
Center at Mercy Medical Center in Baltimore.
Some primary-care practitioners rely on the
Your doctor may prescribe synthetic thyroid hormone pills to compensate for an underactive thyroid. Doria-Medina advises that
caffeine, calcium and fiber supplements can
make thyroid medications less effective.
A healthy diet also supports thyroid function. “Iodine and selenium are essential for
thyroid hormone metabolism, and copper,
zinc and iron are also important,” Doria-Medina says. Aim to get these nutrients from
foods such as shellfish and nuts, and from
iodized table salt.
disease are at increased risk for other autoimmune disorders, including Type 1 diabetes
and rheumatoid arthritis, but most do not
develop these problems. Hypothyroidism has
also been associated with Type 2 diabetes.
While stress does not cause thyroid
dysfunction, it can mimic hypothyroid
symptoms or exacerbate underlying medical
conditions. “Hypothyroidism is relatively easy
to treat with medication, but there is no quick
fix for stress,” Doria-Medina says. Increase
your resilience by eating well and by getting
plenty of exercise and rest.
The Costco Connection
Costco members will find a variety of health
supplements and sleep aids at Costco and
on Costco.com. Prescription medications are
available at most Costco locations.
Addressing lingering symptoms
Some patients experience fatigue, muscle
aches, weight gain and depressed mood after
their thyroid hormone levels are brought into
the desired range. But doctors say you
shouldn’t assume you need more medication.
Too much thyroid hormone can push you into
a hyperthyroid state, characterized by heart
palpitations, nervousness and insomnia.
Many conditions can cause these symptoms, including deficiencies in iron and vitamin D. Poor sleep habits or untreated sleep
disorders may also be to blame. “Sleep apnea is
far more common than people realize, and it
can cause ongoing fatigue and weight issues,”
says Doria-Medina. Your doctor may recommend an overnight assessment in a sleep lab if
she suspects you have a sleep disorder.
Taylor notes patients with Hashimoto’s
Under- or over-treatment of thyroid disorders can exacerbate other health problems,
including diabetes, heart disease and osteoporosis. Get your thyroid hormone levels
retested six to eight weeks after any change to
your prescription. Also inform your endocrinologist about other medications you are taking. Cholesterol medications, lithium, some
antacids, calcium supplements and hormone
replacement therapies can affect thyroid hormone metabolism.
See your physician if you become pregnant or have menopausal symptoms. Pregnant
women usually need additional thyroid hormones to protect against fetal brain-develop-ment abnormalities. Menopausal women
may need to decrease their dose to preserve
Finally, consult your doctor if you gain or
lose a significant amount of weight, Taylor
says. She will assess the potential reasons for
your weight change and determine if your
dose needs adjusting. C
Costco member Heidi Smith Luedtke writes
about health, parenting and people skills.