Could You Have a Thyroid Problem?

The Dangers of 'Explaining Away Your Symptoms'

Mature woman sitting on sofa, looking away in thought
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You may be wondering if you have a thyroid problem. But, if you're like many of the people who write to me every day, you may also be wondering if you're looking too much into symptoms you're experiencing, and perhaps struggling too hard to make a diagnosis fit. Or maybe you worry that trying to figure out if you have a thyroid problem will make you look like a hypochondriac to your doctor, friends, and family.

Most of the symptoms of thyroid conditions are similar to the symptoms of other conditions and health issues. These symptoms don't automatically suggest "thyroid disease" to practitioners, much less patients. Therefore, it's dangerously easy -- and far too common -- for you or your doctor to explain away thyroid symptoms.

After all, you work long hours, take care of your family, juggle many responsibilities, and are getting older... of course you're tired! You don't get enough exercise, and take one too many trip through the fast food drive-through window each week? It's no surprise you're gaining a few pounds! Are you frazzled by a stressful job or responsibilities? It's no wonder you're experiencing anxiety, panic attacks or depression -- they're common in today's hectic and overburdened society. Do you find it hard to concentrate and remember things, notice you're not sleeping so easily, suffering a diminishing sex drive, and your hair is getting thinner?

So, what else is new when you're over 60?

It's very easy to explain away symptoms. For example, a period when hypothyroidism is more common is after having a baby. And what woman who has just had a baby isn't complaining about difficulty losing weight, fatigue, hair loss, and general malaise? Coincidentally, those happen to be the same exact symptoms you might encounter with post-partum hypothyroidism.

Unfortunately, while your symptoms may not be anything more than needing more exercise, or more sleep, or may be normal for a woman for post-partum or menopause, they may point to a diagnosable and treatable condition like thyroid disease.

Compounding the tendency to explain away thyroid symptoms is the fact that, like other autoimmune diseases, the thyroid conditions Hashimoto's Thyroiditis and Graves' Disease also frequently appear during and after periods of great stress -- mental and/or physical. Whether it's coping with another illness, death of a loved one, changes of job or house, going through a divorce, experiencing a car accident -- autoimmune thyroid problems more commonly manifest themselves after these types of crises and stressors. But that's also the same time that you -- and your doctor -- might expect you to suffer symptoms such as fatigue, depression, sleep disorders, and weight changes.

Should You Be Tested for Thyroid Disease? 

Some thyroid experts are suggesting that everyone should have thyroid testing at 35 years of age, and every several years thereafter.

And researchers recently found that thyroid disease is far more prevalent than previously thought. In fact, more than 13 million Americans may have thyroid disease, but be unaware of it, undiagnosed and untreated.

Despite the vast numbers of undiagnosed people, recommendations for widespread thyroid testing have not been widely adopted or followed. The majority of adults, therefore, have never had a thyroid test, and probably won't receive one unless they request it, or their doctor specifically suspects a thyroid problem.
If you suspect you have a thyroid problem, follow these steps:

Familiarize Yourself With Thyroid Disease -- An excellent starting place is a multi-part article, called Thyroid Disease 101: Basic Information on Hypothyroidism, Hyperthyroidism, Nodules, Goiter, and Thyroid Cancer. This article will help you identify the key types of thyroid conditions and their common features.

Assess Your Risks -- What are the key risk factors? Your chance of having a thyroid problem is greater if any of the following are true for you:

  • Family history of thyroid disease -- having parents, grandparents, siblings, and children with thyroid problems significantly increases your risk of also having a thyroid problem
  • Gender -- women are seven times more likely than men to develop a thyroid problem.
  • Age -- the risk of thyroid problems increase with age. By the age of 60, a woman has a one in five chance of having a thyroid problem.
  • Hormonal Change -- the post-partum and menopausal periods seem to be times when women are particularly vulnerable to the appearance of thyroid problems.
  • Other Autoimmune Diseases -- if you or family members of other autoimmune diseases, like lupus, multiple sclerosis, or rheumatoid arthritis, for example, you have an increased risk of thyroid problems.
  • Medications -- the medications cordarone/amiodarone and lithium have the potential to create thyroid problems.

Evaluate Your Symptoms -- The next step is to look at your symptoms. Fill out our Hypothyroidism Risk Factors and Symptoms Checklist, or our Hyperthyroidism Risk Factors and Symptoms Checklist. These checklists are handy tools when talking to your doctor.

You can also perform the "Thyroid Self-Check" at home to assess whether you have an enlarged thyroid, lump, or goiter -- another common thyroid disease symptom.

Thyroid Disease Symptoms

Rapid and inappropriate weight gain or loss, despite diet/exercise
Constipation or diarrhea
Feeling extremely cold or hot
Particularly high or low pulse rate
High or very low cholesterol levels
High or low blood pressure
Fatigue, exhaustion
Hair, skin and nail problems, hair loss
Puffiness, swelling in eyes, face, hands, feet
Pains, aches in joints, hands and feet
Carpal-tunnel syndrome, tendonitis
Irregular menstrual cycles
Infertility, miscarriage
Depression, mood swings
Anxiety, panic attacks
Low sex drive
Sensitive eyes
Heart palpitations
Hand tremors
Hoarse or gravely voice
Neck, throat discomfort, pain, choking feeling

See Your Physician -- If you have any thyroid risk factors, and more than one or two of the thyroid symptoms noted in these checklists, and they've gone on more than a few weeks, you should definitely get your thyroid tested.

Bring your Risk Factors and Symptoms Checklist to the doctor for an evaluation, and request a thyroid test. A Thyroid Stimulating Hormone (TSH) test is a simple blood test, it's not particularly expensive -- a TSH blood test typically runs from around $30 to $100, depending on the lab where your doctor sends tests.

Understand The Diagnosis and Results -- Be sure that you get the specific diagnosis and numerical results of your thyroid test from your doctor. Then, in addition to your doctor's interpretation, you can use the following resources to help understand what the results mean:

Understand the Drug Treatments-- A good starting point for understanding thyroid drug treatments, whether for hypothyroidism or hyperthyroidism, is All About Thyroid Drugs. This article discusses natural and synthetic thyroid hormone replacement drugs, and antithyroid medicines.

Don't miss the Thyroid Drugs Database, for in-depth information on the various drugs, their manufacturers, and prescribing information.

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