Approximately ten percent of Americans suffer from some type of thyroid disorder. Of those ten percent, it is estimated that nearly half remain undiagnosed. Why does thyroid disorder so often go unnoticed, particularly in women? How does the thyroid work, anyway? Once you can begin to understand the answers to these questions, it’s easy to see how this condition might be overlooked or misdiagnosed, even by someone suffering from symptoms.
The thyroid is a large endocrine gland found in the neck. It is controlled by the hypothalamus and the pituitary gland, and is responsible for a number of functions. The thyroid controls how the body responds to other hormones, so when it isn’t working properly, the whole endocrine system may be affected. The thyroid produces the hormones thyroxine (T4) and triiodothyronine (T3), which together regulate the rate of metabolism in the body.
When the thyroid is underactive, the condition is referred to as hypothyroidism, and patients often gain weight because their metabolism slows. When the thyroid is overactive, a condition known as hyperthyroidism, patients often have difficulty putting on weight. While the explanation sounds fairly simple, the thyroid’s actual effects on the body are anything but. Because the thyroid is in charge of how the body responds to other hormones, symptoms of thyroid disorder can range from mild to severe, and they affect people in different ways—making a proper diagnosis a challenge. Furthermore, symptoms of thyroid disorder are nonspecific, and in general may point to any number of other issues. In addition to weight changes, symptoms may include:
• depression and anxiety
• thinning skin or hair
• feeling too hot or too cold
• mood swings
• sleep disturbances
• feelings of apathy
• foggy thinking
Thyroid Disorder Treatment
Emily Davey is a 33-year-old single mother of three. For a few years, she had been suffering symptoms of fatigue, depression, and irritability. Considering the full schedule she keeps, which includes a job and college classes, most would consider this par for the course. “Of course I’m stressed out. But it was more than that, like I was stuck in a fog, and nothing seemed to really be helping. Then my hair started falling out, and I was always cold, even in the summer.” Her regular doctor ran tests, all of which came back normal, including her thyroid, and she started looking for other answers. She ended up in the office of Wendy Parks.
Wendy is a nurse practitioner and co-owner of Integrative Medical Solutions, a family medical practice in Edmond. She sees a number of patients with endocrine issues, and receives referrals from all over the state, partly due to her approach to treating thyroid disorders. “Many providers make the mistake of only checking TSH levels (thyroid-stimulating hormone) in their patients. When that comes back in normal range, these symptomatic patients feel like it’s all in their head, and they can’t get the help they need.”
Instead, Wendy orders a full thyroid panel. “I check TSH, but also total and free T3 and T4 levels and thyroid antibodies. By the time TSH levels are out of range, the T3 and T4 have probably been bad for a long time. You really have to look at how it all breaks down, because it doesn’t take a lot to throw everything off.”
In fact, she estimates that approximately 60% of her patients have some level of thyroid disorder. “If a patient’s levels are borderline and they’re not symptomatic, we won’t treat them right away. But if they are having symptoms, we’ll go ahead and treat them, even if the labs indicate that treatment isn’t strictly necessary. It’s really important to listen to the patient, because these symptoms can affect every aspect of their life.”
Emily is a perfect example. “When we got all the tests back, not only was my thyroid out of balance, my other hormone levels were off. Once I started on the thyroid medication, the rest of it started falling back into place.” Though she’s still stressed, she feels more like her old self, and follows up with Wendy at least twice a year. “I thought my symptoms were just Busy-Mom Syndrome, and I’m sure to some extent, that’s true. But I feel so much better now!”
Shannon Fields is a freelance writer and a Certified Pharmacy Technician at Innovative Pharmacy Solutions.