Optimal Health Medical Blog

The Blog of Dr. Henry Sobo

Tired? Gaining weight? Is it your thyroid?

Tired? Gaining weight? Is it your thyroid?

It has been estimated that thousands of people in our country may be suffering from signs and symptoms of an underactive thyroid, but they have not been correctly diagnosed by their doctors. If you may be one of them, the obvious question is, why has your doctor not diagnosed your condition? The answer may lie in the inexact nature of the blood test most commonly used to make the diagnosis.

It has been estimated that thousands of people in our country may be suffering from signs and symptoms of an underactive thyroid, but they have not been correctly diagnosed by their doctors. If you may be one of them, the obvious question is, why has your doctor not diagnosed your condition? The answer may lie in the inexact nature of the blood test most commonly used to make the diagnosis. In 2003, the American Association of Clinical Endocrinologists formulated new guidelines for the interpretation of thyroid blood tests. They stated that the blood tests as traditionally interpreted left many patients undiagnosed. The suggestion was that the actual normal ranges for thyroid blood tests be changed to help doctors across the country easily make the correct diagnosis in their patients. Despite the fact that this was suggested over 3 1/2 years ago, the lab reports your doctor consults have not been changed. Although some doctors are aware of the new interpretation, many are not. This leaves many people being told by their doctor’s that their thyroid function is normal. A closer look at your lab report might bring that into question.

There are a number of signs and symptoms that people need to be made aware of so that the problem can be understood and brought to the attention of their doctors. If the doctor is, however, unresponsive to these concerns, the patient may be best served by seeing a doctor who is already aware of this issue.

The following paints a picture of what many people may notice about themselves that might cause them to have this looked in to:

If a person’s thyroid has become underactive, which is quite common and even more so in women over 40, they will frequently feel fatigued, and may notice that they have gained weight despite not having changed their dietary habits. If the person goes on a diet, they may see that despite following the weight loss plan they still can’t seem to lose weight.

There are other physical signs to be aware of. Dry skin, and a tendency to bruise more easily may be noticed. Constipation is a very common sign. Along with feeling generally tired, a person might also feel that they are sensing a feeling of weakness. They may feel cold, more than others who they are in the company of, in the same environment.

Facial appearance may change, and the changes may be subtle and occur slowly over time, and thus the patients themselves may be the best to judge that the changes are occurring. The hair and nails may be affected. If a person notices hair falling out at a greater rate than normal, again think thyroid. Other physical sign has to do with hair loss other than on the scalp. A particular well known sign of hypothyroidism is the loss the outer 1/3 of the eyebrows. Loss of hair on the arms and legs and under the arms can also bring into question whether thyroid function may be involved. Another facial characteristic is puffiness of the eyelids and face. Some patients report hoarseness and some difficulty swallowing.

Depression is common in hypothyroidism.  As a resident in Internal Medicine in the 1980’s I remember our chief of staff an elderly doctor nearing retirement at the time, describing how in the days before the blood tests were used to diagnose a thyroid condition doctors had to use their knowledge of the signs and symptoms to make the diagnosis. He observed visits to hospital wards where severe depression was being treated. He saw cases of depression resolved with the diagnosis and treatment of their hypothyroidism.

The effect on the body of thyroid hormone involves so many function that there are many other symptoms as well as the ones mentioned above that may also occur. Menstrual problems such as irregular periods, PMS and or infertility may be a consequence of hypothyroidism. Is your cholesterol elevated?  This, too, may be a sign of an underactive thyroid. Before taking medication to control cholesterol, it may be wise to consider more carefully whether it might relate to an underactive thyroid.

Environmental toxins affect the thyroid. One reason given for the rise of hypothyroidism is that we live in a world polluted by many chemicals, which the human being had never been previously exposed to. Along with these new chemicals is the influence of the class of elements called “heavy metals” such as mercury, lead, and arsenic. All of these substances interfere with proper hormonal functioning in the body. Most doctors do not screen their patients for the presence of these elements, which may be having a profound influence not only on the person’s current health but on their long term risks of health problems. If the heavy metals are present in excessive amounts, there are effective treatments to remove them.

In summary, it is important that the under-diagnosis of hypothyroidism be understood and acted upon. Thyroid hormone plays a part in overall body metabolism and so many functions of the body. There is a very wide array of signs and symptoms that may alert a patient to the possibility that this may be an important disorder to be checked by their doctor(s). Furthermore, for a person to be properly empowered so that they may act upon this knowledge, it should be recognized that many doctors may simply not be responsive to the ideas in this article. This is likely, especially if the doctors rely entirely on the usual screening test for hypothyroidism (the TSH blood test) and declare to their patients that they do not have a thyroid problem — based on the TSH test being within the normal range. In that case, the patient must be assertive enough to find a physician who recognizes these developments in the diagnosis and treatment of this problem.

 

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