According to the American Thyroid Association, women are more likely than men to have thyroid disorder. One in eight women will develop thyroid problems during her lifetime.
Listen in as Dr. Priya Menon, Endocrinologist with Hendricks Regional Health, discusses Thyroid disorders and the treatments available that can help to dramatically increase your quality of life.
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The Latest Treatments for Thyroid Disorders
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Learn more about Priya Menon, MD
Priya Menon, MD
Priya Menon, MD is an Endocrinologist with Hendricks Regional Health Medical Group.Learn more about Priya Menon, MD
Transcription:
The Latest Treatments for Thyroid Disorders
Melanie Cole (Host): According to the American Thyroid Association, women are more likely than men to have thyroid disorder. One in eight women will develop thyroid problems during her lifetime. My guest today is Dr. Priya Menon. She’s an endocrinologist at Hendricks Regional Health. Welcome to the show, Dr. Menon. Give us a little physiology lesson here. What is the function of the thyroid?
Dr. Priya Menon (Guest): The thyroid is a big partner in almost every other system of the body. So, for example, if you have a thyroid problem, it can speed up your heart or slow down your heart. It can cause constipation or it can cause diarrhea depending on the thyroid disease you have. It can cause some memory loss. It is both hyper- and hypo- which is over functioning thyroid or under functioning thyroid and can cause fatigue. You can have sleep disturbances in that you can sleep too much or too little depending on the thyroid disease you have. So, the thyroid really does affect almost all aspects of your life.
Melanie: The thyroid is a gland and it creates this hormone that controls our metabolism. So, all of these symptoms and things that you’re describing, how would we know that those are our thyroid acting up? What are some risk factors and some symptoms? How would we know that that’s our thyroid as opposed to just things we go through sometimes?
Dr. Menon: The thyroid disorders can easily be diagnosed with a blood test. So, oftentimes, women-- particularly women--will complain to their doctors if they have weight gain, fatigue, constipation, or a constellation of symptoms, they will go to their primary care. The primary care then will run the thyroid panel as a part of the test that they run to rule out or rule in thyroid along with other problems. If the thyroid stimulating hormone, or the TSH, is high or low, you can pretty much rule in or rule out a thyroid problem. A normal TSH effectively rules out thyroid disease but if you have an abnormal TSH, then there might be other tests that we might do like an ultrasound or a thyroid uptake scan and we go from there.
Melanie: So, is this a routine blood test? When we get our yearly exam, do you test for thyroid function?
Dr. Menon: It’s not yet a recommendation to test for thyroid function routinely. Usually, it is prompted by a group of symptoms that the patient complains about to the primary care. But, there is a strong feeling among endocrinologists given the fact that hypothyroidism is so common among women and it runs in families, that it might be a good idea to run a TSH as part of our routine annual physical exam.
Melanie: So, tell us: what is hypothyroidism and what does it cause in women? Why are we so susceptible to this?
Dr. Menon: So, hypothyroidism, depending on which part of the world you’re from, can be because of iodine deficiency or because of an autoimmune process where antibodies attack the thyroid gland. In the US, because there’s so much fortification of our food with iodine, for example, our salt is iodized, our flour is iodized, so there is really very little play for iodine deficiency as a cause for hypothyroidism. The vast majority of hypothyroidism in the US is because of autoimmune thyroiditis where antibodies that would be produced against an antigen like a virus can attack our thyroid gland. So, we act against our own thyroid gland and it might result in hypothyroidism. A lot of people can have just thyroiditis and recover after a six- to eight-week period. But, there can be a significant portion of those women or men who ultimately go on to become hypothyroid which means the thyroid is no longer making the thyroid hormone as it’s supposed to do. In that event, we complain of symptoms like fatigue and weight gain, constipation, sleeping too much, being too tired, aching joints, things like that, which prompts a blood test; most commonly a TSH and sometimes a free T4. If there is a high TSH TSH stands for “thyroid stimulating hormone” which is produced by the pituitary and the TSH is high when the pituitary senses that the thyroid gland is really not making enough thyroid hormone. So, high TSH will point to hypothyroidism, in most instances.
Melanie: If you diagnose someone with thyroiditis and whether it’s viral or bacterial or genetics or autoimmune function as you mentioned, what are some of the treatments available? Because they can really affect quality of life, Dr. Menon, and some of the treatments available might dramatically increase that quality of life.
Dr. Menon: You’re exactly right, Melanie. Quality of life is the biggest complaint. Decrease in quality of life is the biggest complaint amongst the women that I see. And, oftentimes, the treatment is really simple. In most instances, supplementation with thyroid hormone in the form of T4 or T3 is acceptable. The majority of the women are okay with T4 supplementation. However, if you look at patient service, about a third of the women come back saying even though their numbers look good, their TSH is in the normal range, they still don’t feel like they’ve recovered or have full quality of life. And, in those instances, we will supplement the T4 treatment with a little bit of T3 which can help greatly.
Melanie: Is this something that now we have to be on for the rest of our lives? Does thyroid function kind of fix itself or are there things we can do that can help it along so that they can get off of medication?
Dr. Menon: For the most part, this is lifelong treatment. Thyroiditis, if it recovers and does not turn into hypothyroidism, will do so the first six to eight weeks. But, after eight weeks, if the TSH is still high, it is here to stay and you’re looking at thyroid hormone supplementation for the rest of your life.
Melanie: Are there any lifestyle modifications because we’ve even heard of thyroid and weight gain. We’ve heard of all kinds of things that affect us as we said the quality of life. Are there some lifestyle tips that you’d like to give, Dr. Menon, that can help women and or men with thyroid disorders?
Dr. Menon: The amount of hormone we give women is dependent, or men for that matter—anybody--is dependent on the weight of that person. So, the heavier you are, the larger your thyroid hormone supplementation will need to be. But weight gain does not cause hypothyroidism. It can just make you take a larger dose than usual. You know, there is a lot of information about cruciferous vegetables like broccoli or that group of vegetables--cauliflower, broccoli--causing hypothyroidism. However, that’s really not borne out in our studies. You’d have to take a lot of broccoli, a lot of cauliflower to really suppress the action of the gland and produce hypothyroidism. So, really, there’s not a whole lot to do to prevent hypothyroidism in our country other than diet and supplementation that is already being routinely done.
Melanie: So then, wrap it up for us, Dr. Menon. Give your best advice about thyroid disorders, what you really want people to know and what you tell them every day about symptoms, red flags, things they really need to watch out for so they can be their own best health advocate and ask their doctor for the test.
Dr. Menon: If you have symptoms that make you feel uncomfortable, you feel like your quality of life is going down. You’re gaining weight. You’re doing everything you can but you just are not able to take the pounds off. If you feel fatigued or constipated or you’re sleeping too much, don’t hesitate to go to your doctor. It’s easy to test and relatively easy to treat, so you lose nothing by requesting thyroid testing or just a general checkup. If it is a thyroid problem, it can be treated fairly easily and simply. So, all I’d say is if you have symptoms, seek help.
Melanie: Thank you so much, Dr. Menon, for being with us today. You’re listening to Health Talk with HRH Hendricks Regional Health. For more information, you can go to www.hendricks.org. That’s www.hendricks.org. This is Melanie Cole. Thanks so much for listening.
The Latest Treatments for Thyroid Disorders
Melanie Cole (Host): According to the American Thyroid Association, women are more likely than men to have thyroid disorder. One in eight women will develop thyroid problems during her lifetime. My guest today is Dr. Priya Menon. She’s an endocrinologist at Hendricks Regional Health. Welcome to the show, Dr. Menon. Give us a little physiology lesson here. What is the function of the thyroid?
Dr. Priya Menon (Guest): The thyroid is a big partner in almost every other system of the body. So, for example, if you have a thyroid problem, it can speed up your heart or slow down your heart. It can cause constipation or it can cause diarrhea depending on the thyroid disease you have. It can cause some memory loss. It is both hyper- and hypo- which is over functioning thyroid or under functioning thyroid and can cause fatigue. You can have sleep disturbances in that you can sleep too much or too little depending on the thyroid disease you have. So, the thyroid really does affect almost all aspects of your life.
Melanie: The thyroid is a gland and it creates this hormone that controls our metabolism. So, all of these symptoms and things that you’re describing, how would we know that those are our thyroid acting up? What are some risk factors and some symptoms? How would we know that that’s our thyroid as opposed to just things we go through sometimes?
Dr. Menon: The thyroid disorders can easily be diagnosed with a blood test. So, oftentimes, women-- particularly women--will complain to their doctors if they have weight gain, fatigue, constipation, or a constellation of symptoms, they will go to their primary care. The primary care then will run the thyroid panel as a part of the test that they run to rule out or rule in thyroid along with other problems. If the thyroid stimulating hormone, or the TSH, is high or low, you can pretty much rule in or rule out a thyroid problem. A normal TSH effectively rules out thyroid disease but if you have an abnormal TSH, then there might be other tests that we might do like an ultrasound or a thyroid uptake scan and we go from there.
Melanie: So, is this a routine blood test? When we get our yearly exam, do you test for thyroid function?
Dr. Menon: It’s not yet a recommendation to test for thyroid function routinely. Usually, it is prompted by a group of symptoms that the patient complains about to the primary care. But, there is a strong feeling among endocrinologists given the fact that hypothyroidism is so common among women and it runs in families, that it might be a good idea to run a TSH as part of our routine annual physical exam.
Melanie: So, tell us: what is hypothyroidism and what does it cause in women? Why are we so susceptible to this?
Dr. Menon: So, hypothyroidism, depending on which part of the world you’re from, can be because of iodine deficiency or because of an autoimmune process where antibodies attack the thyroid gland. In the US, because there’s so much fortification of our food with iodine, for example, our salt is iodized, our flour is iodized, so there is really very little play for iodine deficiency as a cause for hypothyroidism. The vast majority of hypothyroidism in the US is because of autoimmune thyroiditis where antibodies that would be produced against an antigen like a virus can attack our thyroid gland. So, we act against our own thyroid gland and it might result in hypothyroidism. A lot of people can have just thyroiditis and recover after a six- to eight-week period. But, there can be a significant portion of those women or men who ultimately go on to become hypothyroid which means the thyroid is no longer making the thyroid hormone as it’s supposed to do. In that event, we complain of symptoms like fatigue and weight gain, constipation, sleeping too much, being too tired, aching joints, things like that, which prompts a blood test; most commonly a TSH and sometimes a free T4. If there is a high TSH TSH stands for “thyroid stimulating hormone” which is produced by the pituitary and the TSH is high when the pituitary senses that the thyroid gland is really not making enough thyroid hormone. So, high TSH will point to hypothyroidism, in most instances.
Melanie: If you diagnose someone with thyroiditis and whether it’s viral or bacterial or genetics or autoimmune function as you mentioned, what are some of the treatments available? Because they can really affect quality of life, Dr. Menon, and some of the treatments available might dramatically increase that quality of life.
Dr. Menon: You’re exactly right, Melanie. Quality of life is the biggest complaint. Decrease in quality of life is the biggest complaint amongst the women that I see. And, oftentimes, the treatment is really simple. In most instances, supplementation with thyroid hormone in the form of T4 or T3 is acceptable. The majority of the women are okay with T4 supplementation. However, if you look at patient service, about a third of the women come back saying even though their numbers look good, their TSH is in the normal range, they still don’t feel like they’ve recovered or have full quality of life. And, in those instances, we will supplement the T4 treatment with a little bit of T3 which can help greatly.
Melanie: Is this something that now we have to be on for the rest of our lives? Does thyroid function kind of fix itself or are there things we can do that can help it along so that they can get off of medication?
Dr. Menon: For the most part, this is lifelong treatment. Thyroiditis, if it recovers and does not turn into hypothyroidism, will do so the first six to eight weeks. But, after eight weeks, if the TSH is still high, it is here to stay and you’re looking at thyroid hormone supplementation for the rest of your life.
Melanie: Are there any lifestyle modifications because we’ve even heard of thyroid and weight gain. We’ve heard of all kinds of things that affect us as we said the quality of life. Are there some lifestyle tips that you’d like to give, Dr. Menon, that can help women and or men with thyroid disorders?
Dr. Menon: The amount of hormone we give women is dependent, or men for that matter—anybody--is dependent on the weight of that person. So, the heavier you are, the larger your thyroid hormone supplementation will need to be. But weight gain does not cause hypothyroidism. It can just make you take a larger dose than usual. You know, there is a lot of information about cruciferous vegetables like broccoli or that group of vegetables--cauliflower, broccoli--causing hypothyroidism. However, that’s really not borne out in our studies. You’d have to take a lot of broccoli, a lot of cauliflower to really suppress the action of the gland and produce hypothyroidism. So, really, there’s not a whole lot to do to prevent hypothyroidism in our country other than diet and supplementation that is already being routinely done.
Melanie: So then, wrap it up for us, Dr. Menon. Give your best advice about thyroid disorders, what you really want people to know and what you tell them every day about symptoms, red flags, things they really need to watch out for so they can be their own best health advocate and ask their doctor for the test.
Dr. Menon: If you have symptoms that make you feel uncomfortable, you feel like your quality of life is going down. You’re gaining weight. You’re doing everything you can but you just are not able to take the pounds off. If you feel fatigued or constipated or you’re sleeping too much, don’t hesitate to go to your doctor. It’s easy to test and relatively easy to treat, so you lose nothing by requesting thyroid testing or just a general checkup. If it is a thyroid problem, it can be treated fairly easily and simply. So, all I’d say is if you have symptoms, seek help.
Melanie: Thank you so much, Dr. Menon, for being with us today. You’re listening to Health Talk with HRH Hendricks Regional Health. For more information, you can go to www.hendricks.org. That’s www.hendricks.org. This is Melanie Cole. Thanks so much for listening.