Wednesday, March 25, 2015

Could It Be My Thyroid?

Hypothyroidism symptoms can mimic many other disorders, with fatigue, dry skin, changes in hair texture, and weight gain as the early symptoms. If your hormones are declining, these symptoms may sound familiar.

Hashimoto thyroiditis is an autoimmune disease of the thyroid and is the most common cause of hypothyroidism in the United States in patients over 6 years old. Originally thought to be rare, the incidence seems to be increasing, and it has probably been under diagnosed. It is 15 to 20 times more common in women than men.

On initial exam, simple thyroid testing may present as normal. Thyroid testing can include TSH (Thyroid Stimulating Hormone), T3, T4, and if ordered separately, Thyroid Antibody Testing. Usually, TSH is elevated in Hashimoto patients because the body is desperately trying to keep the thyroid levels normal in the serum, so Thyroid Stimulating Hormone is increased by the body and lab values will detect this. The trick is that in some individuals, TSH levels will appear normal, and even 10 to 15% of Hashimoto patients can test negative for thyroid antibodies.

This is when a good patient history can help. Make sure that your doctor knows if your mom, aunt, or other relatives were diagnosed with low thyroid. Treatment is simply taking supplemental thyroid for the majority of patients and this continues for life. If this is not effective, some patients may require dessicated thyroid or even compounded low dose naltrexone therapy to help balance the immune system cell response.

We recently had a patient with normal thyroid levels who was treated with hormone therapy but continued to have symptoms. Fortunately, the patient remembered her family history and asked her doctor to run thyroid antibody testing. She tested positive for thyroid antibodies, and was started on thyroid medication and is feeling much better.

The bottom line is that we are all more than the sum of our lab values. It is important to be an active partner on your health care team. Make sure that your doctor knows your full family history.

Healthy living with John Hollis Pharmacy!

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