What is Thyroid Health?

By: Preethi Kadambi, M.D.

Are there days when your energy level is so high you feel like you could run a marathon? Or do you have days you struggle to get out of bed in the morning because you feel fatigued or depressed? In both cases, the cause of your problem may be your thyroid.

The thyroid, a butterfly-shaped gland in the front of your neck, makes hormones that control the way your body uses energy. Your thyroid controls your metabolism, which is how your body turns food into energy, and also affects your heart, muscles, bones and cholesterol.

The most common thyroid problems involve an abnormal production of thyroid hormones. Too much of these vital body chemicals results in a condition known as hyperthyroidism. Too little hormone production leads to hypothyroidism.

Although the effects of thyroid problems are unpleasant or uncomfortable, most thyroid conditions can be managed well if properly diagnosed and treated.

What is an overactive thyroid?
Hyperthyroidism happens when the thyroid becomes overactive and produces too much of its hormones. Hyperthyroidism affects women 10 times more often than men, and is most common in people aged 20 to 40. People with hyperthyroidism have problems that reflect over activity of the organs of the body, resulting in symptoms such as sweating, feeling hot, rapid heartbeats, weight loss and sometimes eye problems.

What is an underactive thyroid?
Hypothyroidism, by contrast, stems from an underproduction of thyroid hormones. Since your body's energy production requires certain amounts of thyroid hormones, a drop in hormone production leads to lower energy levels, causing you to feel weak and tired.

Hypothyroidism is more common in women and also tends to run in families.

If hypothyroidism is not treated, it can raise your cholesterol levels and make you more likely to have a heart attack or stroke. During pregnancy, untreated hypothyroidism can harm your baby. Luckily, hypothyroidism is easy to treat.

How is hyperthyroidism treated?
Hyperthyroidism is easily treated. With treatment, you can lead a healthy life. Without treatment, hyperthyroidism can lead to serious heart problems, bone problems, and a dangerous condition called thyroid storm.

If your symptoms bother you, your doctor may give you pills called beta-blockers. These can help you feel better while you and your doctor decide what your treatment should be. Even if your symptoms do not bother you, you still need treatment, because hyperthyroidism can lead to more serious problems.

Radioactive iodine and anti-thyroid medicine are the treatments doctors use most often. The best treatment for you will depend on a number of things, including your age. Some people need more than one kind of treatment.

After treatment, you will need regular blood tests. These tests check to see if your hyperthyroidism has come back. They also check to see if you are making enough thyroid hormone. Sometimes treatment cures hyperthyroidism but causes the opposite problem, -- too little thyroid hormone. If this happens, you may need to take thyroid hormone pills for the rest of your life.
How is hypothyroidism treated?

Doctors usually prescribe thyroid hormone pills to treat hypothyroidism. Most people start to feel better within a week or two. Your symptoms will probably go away within a few months. But you will likely need to keep taking the pills for the rest of your life.

In most cases, thyroid hormone medication works quickly to correct symptoms. People with hypothyroidism who take thyroid hormone medication usually notice:

• Improved energy level
• Gradual weight loss (in people with severe hypothyroidism at the time of diagnosis)
• Improved mood and mental function (thinking, memory)
• Improved pumping action of the heart and improved digestive tract function
• Reduction in the size of an enlarged thyroid gland (goitre), if you have one
• Lower cholesterol and triglyceride levels

It's important to take your medicine just the way your doctor tells you to. You will also need to see your doctor for follow-up visits to make sure you have the right dose. Getting too much or too little thyroid hormone can cause problems.

If you have mild (subclinical) hypothyroidism, you may not need treatment now, but you'll want to watch closely for signs that it is getting worse.

- Dr. Preethi Kadambi is an endocrinologist with University of Maryland Center for Diabetes and Endocrinology at Baltimore Washington Medical Center in Glen Burnie. To reach Dr. Kadambi, please call 410-787-4940.