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Understanding Thyroid Disorders

by Joy Hought

Geriatric Times July/August 2003 Vol. IV Issue 4

The thyroid is a butterfly-shaped gland located in the lower neck, just above the collarbone. When it makes too much or too little thyroid hormone, many parts of your body may not work properly. About 27 million Americans have thyroid disorders; eight out of 10 of them are women. More than half of those with thyroid disorders have never been diagnosed.

There are two forms of thyroid disease: overactive (hyperthyroidism) and underactive (hypothyroidism). Both occur more often in older adults. Because many of the symptoms seem to be normal signs of aging, both patients and doctors can overlook them. If you are healthy, your doctor should check your thyroid if you suddenly notice any of the following:

If thyroid disease is not treated, it can lead to serious long-term problems such as high cholesterol levels, heart disease, muscle weakness and osteoporosis. Your doctor can order simple and inexpensive blood tests to find out if you have high or low thyroid hormone levels and prescribe any needed treatment.

Hyperthyroidism

In this disorder, the thyroid gland has grown bigger and/or makes too much thyroid hormone.

Symptoms. Although these are not always seen in older adults, symptoms of hyperthyroidism may include:

Tests. A blood test measures whether you have low levels of thyroid-stimulating hormone (TSH) and high serum concentrations of thyroid hormones. You may also undergo a radioactive thyroid scan so your doctor can find out if the whole thyroid is overactive or if only part of it is overactive (hyperfunctioning).

Treatment options. Your doctor may prescribe radioiodine, a pill that slows down your thyroid. Because radioiodine works by destroying thyroid tissue, your thyroid will need to be monitored for the rest of your life. Antithyroid medicines, such as propylthiouracil or methimazole (Tapazole), are used less often. In very rare cases, part or all of the oversized thyroid may need to be surgically removed.

Hypothyroidism

In this disorder, thyroid hormone production slows down, usually with age. It is more common in women than in men. Although it is usually not life-threatening, when hypothyroidism is found and treated, its symptoms get better.

Symptoms. Hypothyroidism starts slowly and symptoms may include:

A physical exam is not enough to diagnose hypothyroidism. Your doctor may ask if you or a close relative has any of the following: premature graying of the hair, bulging eyes, a juvenile type of diabetes that requires insulin treatment, rheumatoid arthritis, patchy hair loss or white skin spots called vitiligo. These are not symptoms of thyroid disease, but they are sometimes associated with it.

Tests. A blood test can determine if TSH levels are above normal as well as if there are below normal amounts of the thyroid hormone thyroxine (T4).

Treatment options. Not all patients with high TSH levels will have full thyroid failure. If you have no other symptoms, you and your doctor may decide to wait a year and measure again. A trial of thyroid hormone may help if you have symptoms of fatigue, constipation or poor energy.

For more information on thyroid disorders, contact:
American Thyroid Association
www.thyroid.org
Thyroid Foundation of America
www.allthyroid.org
Thyroid Awareness Month 2003 (American Association of Clinical Endocrinologists)
www.aace.com/pub/tam2003/index.php