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The thyroid gland plays a vital role in your body’s functionality, helping to regulate your metabolism and thereby affecting a wide range of functions, including breathing, sleep, mood, energy, weight and digestion. It’s estimated that 200 million people worldwide have a dysfunctional thyroid and that one in eight women will contract a thyroid disease in their lifetime. Thyroid disease is particularly common in the Middle East, affecting up to 47% of the population in some countries.
The good news is that most thyroid conditions can be corrected, either by lifestyle changes such as diet or through hormone replacement therapy (HRT).
Why your thyroid is important
As a doctor focusing on women’s health, I have come across many cases of thyroid disease. In general, one of three things occur: the thyroid becomes overactive, underactive or grows abnormally.
Overactivity: When thyroid overactivity (hyperthyroidism) occurs, too much T4 and T3 is produced, which speeds up the body’s processes, causing nervousness, anxiety, rapid heartbeat, shakes, sweating, weight loss and sleep disruption. It is most commonly caused by an autoimmune condition called Graves’ disease, in which the immune system attacks the thyroid, causing it to release more hormone than needed. The cause of Graves’ disease is unknown, although, many factors, including genetics, gender, stress, and smoking play a role.
Underactivity: A more common condition is underactive thyroid (hypothyroidism). Here the thyroid produces reduced levels of T4 and T3, resulting in symptoms such as fatigue, weakness, weight gain, depression, constipation, irritability, irregular periods, low libido, feeling cold, memory loss, hair loss, poor skin condition, and even infertility. A dysfunctional thyroid can make it hard to conceive because elevated or suppressed thyroid hormones shorten the menstrual cycle, affect the eggs and alter the production of hormones like prolactin and globulin, which are needed for normal ovulation.
A dysfunctional thyroid can make it hard to conceive because elevated or suppressed thyroid hormones shorten the menstrual cycle, affect the eggs and alter the production of hormones like prolactin and globulin, which are needed for normal ovulation.
In developing countries this underactivity is commonly caused by iodine deficiency, but the most common cause is an autoimmune condition called Hashimoto’s thyroiditis, in which the body attacks the thyroid gland and makes it less efficient at producing hormones.
Abnormal growth: Somewhere between 50% and 67% of people in the world also have abnormal lumps on their thyroid, called nodules, which become more common with age and are more prevalent in women. In most cases these are fluid-filled cysts or pockets of extra thyroid tissue and are mostly harmless. But a small percentage – around 12% – can be cancerous.
Because of the lack of publicity about thyroid disease, it is rarely detected early on. Affected patients tend to experience lots of seemingly unrelated symptoms and have no idea that they can all stem from the same source. A patient suffering with heart palpitations, feeling hot, shortness of breath, insomnia, diarrhea, irregular periods or a combination of these symptoms is unlikely to report to their doctor that their thyroid needs examining. Similarly, a patient who frequently feels cold, tired, constipated and depressed is more likely to assume the problem is sleep, diet or just their time of life.
Affected patients tend to experience lots of seemingly unrelated symptoms and have no idea that they can all stem from the same source.
Detecting and treating thyroid disorders
In most cases a blood test to measure thyroid hormone levels is all that is needed. Patients with thyroid overactivity will usually have raised levels of T3 and T4, while those with an underactive thyroid will have reduced levels. Doctors also tend to measure levels of thyroid stimulating hormone (TSH), the substance that triggers thyroid hormone release.
As thyroid disease often presents as a myriad of symptoms, doctors must also rule out other conditions when making a diagnosis. This includes testing for deficiency of other hormones such as cortisol, oestrogen and progesterone; nutritional deficiencies, especially iron, vitamin D, iodine and selenium; and autoimmune disorders.
The lifestyle factor
When lifestyle factors such as nutritional deficiencies are diagnosed, correcting these factors may be enough to correct the thyroid condition.
Stress, smoking and lack of nutrients such as calcium, iron, vitamin D, selenium and iodine, are all associated with an increased risk of developing thyroid disease. These nutrients can be replenished by following a controlled diet or a course of herbal remedies. Foods rich in the vitamins and minerals you need include eggs, oily fish, leafy green vegetables, beans, nuts and seeds.
Stress, smoking and lack of nutrients such as calcium, iron, vitamin D, selenium and iodine, are all associated with an increased risk of developing thyroid disease.
In cases where these lifestyle changes are not enough to remedy the symptoms, medical intervention is readily available. Patients with an overactive thyroid can be prescribed medication that partially blocks the production of T3 and T4.
Underactive thyroid can be treated with HRT to top up the levels of T3 and T4 and this treatment usually remains in place for life. Bioidentical hormone replacement therapy (BHRT) uses hormones that are identical to those produced naturally by the thyroid. These can be man-made or obtained from desiccated animal tissues. Popular man-made hormone replacements include Cytomel (T3) and Levothyroxine (T4), the latter being more commonly prescribed because T4 is the hormone that the thyroid naturally makes more of and it gets converted to T3 in the body.
Before taking any hormone replacements, it’s essential that you undergo proper testing.
Don’t be afraid to get diagnosed
In most cases thyroid disease is easily treated. The more we can share knowledge about this vital little gland, the more women we can help to lead a normal, healthy, energetic lifestyle.
I will leave you with three simple facts to remember.
Firstly, while genetics does influence your risk of developing the thyroid disease, a balanced diet and low stress lifestyle help to minimise this risk.
Secondly, if you experience any of the symptoms I’ve mentioned, see your doctor to check whether it could be thyroid disease.
Finally, don’t worry. Thyroid disease is very common and very treatable, so if you’ve been recently diagnosed, start looking forward to feeling happier and healthier from now on.