A healthy thyroid may be the key to a healthy heart

A healthy thyroid may be the key to a healthy heart

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List the ABCs of heart health, from arrhythmia to Zumba classes, and you might not think to include a T for thyroid. But the tiny gland that produces crucial hormones can have a big effect on the cardiovascular system.

“Both an overactive thyroid and an underactive thyroid can have bad cardiac consequences,” said Dr. Anne Cappola, endocrinologist and professor at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. “It’s important to recognize and address both.”

The changes caused by an abnormal thyroid can be subtle, said Dr. Robert Carey, an endocrinologist and dean emeritus of the University of Virginia School of Medicine in Charlottesville.

“Thyroid disorders take over you,” he said. “They come on so gradually that they often go undetected until you see a doctor. But the risks of ignoring them are largely cardiovascular.”

The thyroid gland, located at the base of the neck, releases hormones that regulate metabolism and affect all organs, including the heart. When the body produces too much thyroid hormone, hyperthyroidism results, which can cause an irregular heartbeat that can lead to blood clots, strokes, and heart failure, as well as osteoporosis and other problems.

Treatments include drugs, radioactive iodine to shrink the thyroid and, less commonly, surgery to remove it.

Hypothyroidism, when the body does not produce enough hormones, is much more common. This can lead to a slower heart rate, constricted blood vessels, increased blood pressure, fluid retention, and increased cholesterol levels. He is being treated with a drug that replaces this body’s natural thyroid hormones and can manage the disease for a lifetime.

According to the American Thyroid Association, about 1 in 8 people in the United States will develop thyroid disease in their lifetime, and an estimated 20 million currently have it. Women are five to eight times more likely than men to have thyroid problems, and more than half of people with the condition may not be aware of it.

So what should we do about it? Thyroid abnormalities are usually discovered by blood tests. Because heart disease and thyroid problems are linked, Cappola said, people with heart conditions ranging from irregular heartbeats to high cholesterol to heart failure have regular thyroid checks.

“You have to see if the thyroid is a contributor,” she said. “The beauty of it is that you’re treating the thyroid problem, and it often helps the heart problem.”

But Cappola said thyroid tests are not usually part of routine health screenings, in which people without symptoms are tested, as is the case with screening mammograms and colonoscopies.

“The challenges have been who needs to be screened (for thyroid issues), do we recommend screening asymptomatic people and is there a benefit to that,” she said. “We’re not at the point where we’re saying people without symptoms need to be screened.”

That’s why paying attention to symptoms is so important, Cappola and Carey said. Symptoms of hypothyroidism include fatigue; weight gain; cold intolerance; joint and muscle pain; constipation; and dry, brittle hair. For hyperthyroidism, symptoms include weight loss despite increased appetite; fast or irregular heartbeat; nervousness or irritability; muscular weakness; and heat intolerance.

While not everyone feels lazy or nervous having a thyroid problem, especially during a pandemic that has generated stress and social isolation, the overall message is the same.

“For the audience, pay attention to the small changes,” Carey said. “And for clinicians and primary care physicians, feel free to screen for thyroid issues.”

Cappola also drew attention to people who don’t see doctors at all.

“People who never go or don’t clear their symptoms or don’t have access to health care are the ones who could be in trouble,” she said. “You need to have a properly functioning thyroid.”

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Provided by the American Heart Association

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