Be Well, Marsha: 10/27/15

 The gland that rules

By Marsha Bonhart

It’s shaped like a butterfly, but if it’s out of order, it can sting like a bee. The right and left lobes create its wings, and the other element of that grouping is cone-shaped. All three of those parts rest against and around the trachea and larynx. At your throat, touch your “Adam’s apple” and trace the space just below. That’s where you will find your thyroid gland.

Controlled by the pituitary gland, the thyroid is one of the largest of the endocrine system’s glands. It uses iodine to produce the hormones thyroxine (T4) and triidothyronine (T3, more powerful than T4). Another hormone, calcitonin, helps orchestrate the metabolism of calcium and phosphorus. All of those hormones help organs work well, actually determining the rate of the brain, liver, heart, muscles—and controlling how the body uses food for energy. The pituitary checks how much thyroid hormone is being released in the bloodstream. It’s the boss when it comes to your thyroid making enough to keep you well.

Dr. Joyce Shin is an endocrine surgeon with the Cleveland Clinic. Her target specialties are the pancreas, parathyroid and thyroid. In a recent conversation, Dr. Shin points out that thyroid problems can affect both genders, but women who have undiagnosed symptoms often confuse an overactive thyroid, or hyperthyroidism (too much T4), with menopause. Hot flashes, hair and sleep loss, heart palpitations and decrease in bone density all can be connected to an overactive thyroid. Treatment options include anti-thyroid medications, radioactive iodine to slow the production of thyroid hormones and, sometimes, surgery that removes all or part of the gland.

It’s the opposite with hypothyroidism. Think of that condition as the slow ticking of a clock, creating increased sensitivity to cold, depression, forgetfulness, dry skin and hair, brittle nails, weight gain, severe fatigue, infertility, high cholesterol, constipation and missed menstrual cycles. Information from the Hormone Health Network indicates hypothyroidism can also result in higher blood pressure, which creates increased strain on the heart and increased stiffness of the heart wall, potentially leading to that organ’s enlargement. Synthroid, a human-made thyroid hormone, is the most common medication prescribed to treat that condition.

“The weight gain that often accompanies hypothyroidism is a funny thing,” says the Cleveland Clinic’s Dr. Mario Skugor in an Everyday Health interview. “If a person with underactive thyroid can force him or herself to maintain a normal activity level, he or she may only gain a few pounds,” he says. “But some people with hypothyroidism feel so tired they stop exercising, sleep more, and change their routine, which causes more weight gain.”

Blood tests that look for TSH (thyroid stimulating hormone) levels usually determine the gland’s status, but Shin says she gets even more refined results with an ultrasound where she looks for lesions on the thyroid itself. The imaging can pick up the presence of a nodule, or lump, which, in some cases, can be cancerous.

In an interview with Taryn Brill of Everyday Health, Dana Trentini says after the birth of her first child, she had no energy and was concerned because other mothers at outings were more active with their children than she. Her hair was falling out, she lost one third of an eyebrow and constant colds and infections had been plaguing her for more than a year.

“I would have carried on,” Trentini says, “I was assuming that I was getting older and these were normal things that were happening to me.” At the time, the new mother was not even 40-years-old, so that part of her aging process had not quite caught up with her. Trentini was finally diagnosed with hypothyroidism and is now lobbying for thyroid testing to be pre-natal standard screening for every pregnant woman. “What I’m hoping to come out of this is, maybe some doctors will say, ‘hey, I haven’t read these guidelines, maybe I will take a look’.”

If you are suffering from any of the symptoms mentioned in this column, check with your primary care physician or an endocrinologist.

Be well,

Marsha

Marsha Bonhart is a veteran television news anchor and health reporter who feels it is her mission to help you stay healthy. She says she battles her seriously addicted craving for salty potato chips. Reach her at MarshaBonhart@DaytonCityPaper.com.

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