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Health Healthy Woman MagazineShould your thyroid be tested?Tired all the time? Fatigue is just one of many symptoms related to thyroid disorders By Melanie Chambers Lisa Pineault, 32, feels like she lost her 20s. When all her friends were dating and going to parties, she was too tired to socialize and it showed. Pineault's skin and hair were dry and brittle and she was gaining weight. “I wasn‘t enjoying life. I kept saying to myself that I was lazy and that I had to workout more. I didn't know what was happening to me.” Luckily, someone did. During New years' supper 1999, a doctor friend noticed her puffy neck and asked if she had a thyroid problem. Pineault was eventually diagnosed with hypothyroidism, the most common type of thyroid disease. The thyroid, a butterfly-shaped gland located under the Adams 's apple in the neck, affects a wide range of bodily functions from energy level to memory. It releases several hormones that modulate your metabolism—too much and the body speeds ups (hyperthyroidism), not enough thyroid hormone as in Pineault's case, and everything slows down (hypothyroidism). Pineault eventually had her entire thyroid removed because of pre-cancerous nodules and is now on a thyroid replacement medication for life. Looking back, she wonders if she might have had her condition diagnosed sooner. “But it's not like you wake up one morning and its there. Its not like diabetes—there's no real markers. Its gradual.” Susan Aitken was a vivacious 15-year-old excitedly in the midst of a teen adventure. Living in Germany as part of an exchange program, she had every reason to be enthusiastic about this new chapter of her life—and she was, until she suddenly became depressed and starting losing her hair and her eyesight. “I thought I was going nuts,” says the now-26-year-old Halifax N.S.-native (she was raised in London Ontario ). “Doctors couldn't figure out what was wrong with me. They tested me for mononucleosis, they thought I was suffering from clinical depression and wanted to put me on antidepressants.” Eventually she was diagnosed with hypothyroidism. Pineault and Aitken are among the millions of Canadians suffering from thyroid disorders. One in 20 Canadians have some type of thyroid disease and it's five to seven times more common in women than men. According to Stuart Kreisman, clinical assistant professor at the University of British Columbia 's department of endocrinology, that's because women are more susceptible to endocrine glandular disorders. While hyper- and hypo-thyroidism are the most prevalent forms of thyroid disease, there are others, including graves' disease (a type of hyperthyroidism caused by an abnormality in the immune system; postpartum thyroiditis, an inflammation of the thyroid gland that can occur after giving birth and usually resolves itself within several months; and thyroid cancer, which requires a biopsy for diagnosis . The majority of thyroid nodules, generally over 95%, are benign says endocrinologist Dr. Liam Murphy at the Health Science Centre in Winnipeg Manitoba . Thyroid disorders are largely hereditary, but there are numerous other factors that can put one at risk. Overt risk factors for thyroid cancer include radiation therapy to the head or neck. Certain drugs, such as lithium for psychiatric ailments and the heart drug amiodarone (Cordarone) can also increase the odds of suffering from a thyroid condition. After changing doctors several times (between Germany and Canada ) who didn't know enough about thyroid issues, Aitken took it upon herself to become educated. She read books like: Thyroid Power: Ten Steps to Total Health by Richard Shames and Karilee H. Shames. Aitken's disorder was discovered early and she was treated quickly. As with many other illnesses, early detection can greatly affect prognosis, and that detection is fairly simple; a simple blood test can diagnose both hypo- and hyper-thyroidism, which measures blood levels of thyroid stimulating hormone (TSH) in the blood. But because thyroid symptoms are similar to signs of stress, aging or general malaise (see sidebar: Symptoms of thyroid disease), many patients go undiagnosed. That's why some doctors recommend that women over age 40 be tested regularly, whether or not they have symptoms, or not. Maud Wade, 76, remembers the exact day thyroid problems hit. At the time, she was a 42-year-old school secretary. “I was taking a phone message and my hand was shaking,” says Wade. “I thought, ‘that's weird.' The next day it was worse. My penmanship was illegible. I felt as if I was on edge.” As symptoms progressed, Wade's weight plummeted from 110 pounds to 92 pounds, her eyes began to bulge and her heart raced at 120 beats per minute—all classic signs of hyperthyroidism. Wade was diagnosed with Graves Disease. Like most others diagnosed with hyperthyroidism, she was treated with radioactive iodine (most often given in pill or liquid form) that is intended to actually damage, or disable, a large portion of the thyroid. In addition to radioactive iodine, people with hyperthyroidism may be treated with antithyroid agents, which interfere with the synthesis of thyroid hormones. If radioactive iodine or medication is not appropriate, surgery may be an option. If it's only a single nodule that's overactive, only that part will be removed. Sometimes the whole gland or many nodules are dysfunctional, in which case most of the thyroid will be removed. Removal of the thyroid can result in hypothydroidism, which means making a thyroid hormone supplement for life. According to Dr. Kreisman, Surgery is rarely done, as “damage to the voice box and cells that control calcium is a low but unnecessary risk given other treatment options.” Those suffering from insufficient thyroid-hormone levels, or hypothyroidism, are treated with a synthetic thyroid hormone, which needs to be taken for life in order to prevent symptoms from reappearing. “In the first few years medication should be adjusted as the thyroid stabilizes,” says Dr. Ronnie Aronson, an endocrinologist and director of Lifestyle and Metabolism Centres in Ontario Also, dosages should be checked if weight increases, or if iron supplements are taken, since iron reduces the absorption of thyroid . Both Pineault and Aitken need to take on thyroid hormone replacement pills every day for life. It's a price the two seem more than willing to pay in order to feel energized and healthy. “Thyroid disease is a part of me, and I know my limits,” says Aitken. “I don't exhaust myself trying to do things my body doesn't want me to do. If I didn't have thyroid disease I'd probable try to burn the candle at both ends and in the middle, so the imbalance kinda keeps me balanced in a way.” It took Pineault two years to get the right dosage but now she feels alert. “No more feeling like a zombie. It has been years since I have felt this good physically, I have energy and I can move. I sleep 8 hours a night and I now have a clear mind and I am present in all areas of my life!” Thyroid disorders can wreak havoc on women's physical and mental well-being, but with proper medication and an awareness of your energy levels, things don't have to speed up or down. As these women can attest, you can lead a normal life. WEB SITES: www.thyroid.ca The official web site of the Thyroid Foundation of Canada. www.mythyroid.com Part of the University of Toronto Health Network . www.thyroid.org American Thyroid Association web site. Symptoms of thyroid diseaseHyperthyroidism:
Hypothyroidism:
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