| Visiting the Doctor - What You Should Know |
| AWARENESS SUPPORT ADVOCACY for Western Australians |
| Who has autoimmune thyroid disease? Autoimmune thyroid disease (Hashimoto’s thyroiditis and Graves’ disease) is very common and it can affect any age group. Hashimoto’s thyroiditis is more frequently diagnosed in women, who are in their forties or fifties and older. Thyroid disease affects men as well. However men often go under the radar and thyroid disease is usually not suspected. Hypothyroidism can affect overweight people and slim people. Weight gain can be a symptom of hypothyroidism, but the weight gain is not significant in all patients with hypothyroidism. Hyperthyroidism can cause weight loss, but many patients with hyperthyroidism are overweight and hyperthyroidism or excessive thyroid hormone replacement can even contribute to weight gain. Could I have a Hashimoto’s or Graves’ disease (autoimmune thyroid disease)? Autoimmune thyroid disease (Hashimoto’s thyroiditis and Graves’ disease) often runs in families. Other autoimmune diseases like rheumatoid arthritis, type 1 diabetes and coeliac disease can also be seen in people with a family history of autoimmune thyroid disease. If you have a family history of autoimmune disease, you can ask your doctor for a thyroid function test and you should be screened for thyroid antibodies. Thyroid disease is often misdiagnosed or it may be masked by other conditions. These conditions may either be associated with thyroid disease or they may be symptoms of thyroid disease:
Thyroid disease can change your personality, but often the changes are very subtle. If you are developing an underactive thyroid then perhaps you don’t have as much energy, or you have become withdrawn socially and your moods are unstable. These symptoms can be reversed with the right dose of thyroid hormone. Thyroid disease can affect you physically, emotionally and mentally. I want to get pregnant, should I have a thyroid function test? YES, whether you have a family history of thyroid disease or not! Pregnant women require on average an additional 30 to 50 per cent of thyroxine for their baby’s brain development, but if you are in the early stages of autoimmune disease (Hashimoto’s thyroiditis) or if there is a lack or excess of iodine in your diet, then your body may not be able to produce more thyroxine. In the first trimester the foetus relies 100 percent on the maternal thyroid hormone production. After 13 weeks the foetus starts to produce thyroid hormone, but still relies on the maternal thyroid hormone production. Results from human and animal research consistently show that the mother’s thyroid hormone production during pregnancy has a significant long term impact on the behaviour, locomotor ability, speech, hearing and cognition of her children. Lower IQ, difficulties with reading and language, visio-spatial impairments have all been observed when compared with children whose mothers were not hypothyroid during pregnancy. All newborns in Australia are being screened for hypothyroidism and hyperthyroidism. Usually this is done at the hospital upon birth (test is also known as the ‘heel prick’). Congenital hypothyroidism is relatively rare. Hypothyroxinemia (low or low normal thyroxine levels) occurs 150 times more frequently than congenital hypothyroidism! Although some authorities suggest to screen mothers for hypothyroidism, unfortunately it is still not done. Studies that looked at the first trimester maternal thyroxine level (free T4), but NOT the maternal TSH, concluded that a low supply of maternal thyroxine was a significant predictor for future neurodevelopmental difficulties. If a doctor does check for thyroid dysfunction, then generally the TSH is checked (standard test to diagnose and treat hypothyroidism) and therefore the doctor may miss the diagnosis. The GP may also not be familiar with trimester-specific ‘normal’ TSH ranges for pregnant women. Once pregnant the TSH decreases significantly! Your thyroxine level (free T4) should be in the upper third of the normal scale! What do I need to know before I visit the doctor? Thyroid dysfunction can cause many symptoms and affect every organ in your body. Your thyroid related symptoms also occur in other conditions, so often the doctor might treat your symptoms and the real culprit, your ailing thyroid, is not discovered. If your doctor does check your thyroid function, then the doctor may only check your TSH (thyroid stimulating hormone). If your TSH level falls anywhere within the ‘normal range’ then your doctor may tell you that the test is normal, but this test does not rule out hypothyroidism. In some people the TSH is very sensitive and reliable, but in others it is not. If you have classic symptoms of hypothyroidism, antibodies present, family history and low circulating thyroxine levels then there is a good chance that you are in the early stages of thyroid disease. In this case you should not let your doctor dismiss thyroid disease and seek a second opinion. Your health is your responsibility. You should ask for a thyroid function test and ask for a copy. Blood tests should be used as a guide and should not replace clinical evaluation (classic symptoms and signs). I was diagnosed with Hashimoto’s. The doctor won’t prescribe me thyroxine, but he has given me a prescription for anti-depressants. I am not sure if I should take it or not. Too many thyroid patients are prescribed antidepressants instead of an optimal dose of thyroid hormone. There is no reliable diagnostic test to measure any neurotransmitters (brain chemicals) in the brain. Prescribing antidepressants is based on pure guess work. There is no way of knowing if the patient either has a deficiency or an excess of any neurotransmitter other than thyroid hormone. Depression or dysthymia (low mood, low drive and low motivation) is a classic symptom of hypothyroidism, yet many doctors believe it is unrelated. Antidepressants come with a black box label (a warning that the drug may cause suicidal thought and behaviour). Yet providing thyroid patients with an optimal dose of thyroid hormone, which may result in a subsequent low TSH in some people, is seen as a dangerous practice by some doctors even if the patient shows no overdose symptoms, has normal thyroid hormone levels, responds well to thyroxine and appears to be in excellent health. If you are on antidepressants already, then do not withdraw from your medication without the help of your doctor, as this can be dangerous! For us it is about the quality of life! It is not OK to suffer with a high normal TSH and you should be fully functional, be a good mother or father and you should do well in whatever you choose to do. Disclaimer The information provided is for educational purposes only and is not intended to be medical advice. The contents must not be relied upon in place of advice and treatment from a qualified medical practitioner. Thyroid WA Support Group Inc. and the author disclaim any liability whatsoever. Copyright © Monique Atkinson 2012 |
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Thyroid WA Support Group Inc. - ABN 84 263 220 330
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