As one of the major glands that controls cellular function, the thyroid can take credit for helping with much of the inner workings of the human body. However, it’s also an easy, and often wrong, place to blame when something goes wrong.
“There is so much misinformation about thyroid disease that it’s hard to know where to start,” said Dr. Monica Moreno, an endocrinologist for Intermountain Medical Group and sees patients at the Intermountain St. George.
While the three main thyroid-related problems – hypothyroidism, hyperthyroidism and thyroid nodules – are very real and may require medical attention, Dr. Moreno said it’s important for patients to consider it there may be other underlying causes contributing to things like fatigue and weight fluctuations. .
“Our lives are stressful. A person’s diet may not be good. They are busy and work long hours, which can lead to feelings of fatigue, weight gain, mood swings, hair loss, brittle nails and dry skin,” Dr. Moreno said. “Because these can be symptoms of hypothyroidism, people often want to blame it, rather than addressing stress and lifestyle which could also be contributing factors.”
In order to determine if these issues are thyroid-related, the symptoms must be correlated with a lab test, usually available from the patient’s primary care physician, Dr. Moreno said.
“If the tests are normal, that’s not always what the patient wants to hear,” Dr. Moreno said. “People want an explanation for their fatigue that goes beyond stress or lifestyle. They often want something that can be treated with a pill.
If the diagnosis is related to hypothyroidism, medications are often used to treat the problem.
“Some patients may have transient hypothyroidism that comes and goes; others will need lifelong medication,” Dr. Moreno said.
Hypothyroidism, which is a deficiency in the production of thyroid hormone by the thyroid, is more common than hyperthyroidism, which is an overproduction of thyroid hormone. According to Dr. Moreno, a primary care provider can easily manage most cases of hypothyroidism. If the problem is hyperthyroidism, an endocrinologist will often be involved.
“Hyperthyroidism is not a chronic condition like hypo,” Dr. Moreno said. “Usually medication or oblation surgery can help resolve the hyperthyroid problem.”
“The most common cause of hypothyroidism is autoimmune,” Dr. Moreno continued. “The distinction to remember is that Hashimoto’s disease is the disease that can cause hypothyroidism, but hypothyroidism doesn’t cause Hashimoto’s disease. It only goes one way.”
Regarding thyroid nodules, Dr. Moreno said that up to 50% of the population can have nodules without even knowing it; and 90-95% are non-cancerous.
“We don’t have any screening recommendations for nodules because even the small percentage that might be cancerous is a very slow growing cancer,” Dr. Moreno said.
Thyroid nodules are often discovered incidentally, when the patient is examined for something else.
Generally, women are more affected by thyroid problems than men, Dr. Moreno said. “There are two peaks for women when they can see a problem, during childbearing age (20 and 30) and during menopausal age (40 or 50). However, I see patients aged 16 to 85 for hypothyroidism.
While prevention is always a good health idea, there isn’t much you can do to prevent thyroid problems beyond a basic healthy diet.
“Sometimes things like thyroid nodules happen and we don’t know why, but it doesn’t seem to be lifestyle related,” Dr. Moreno said. “Still, a healthy diet and lifestyle will help with everything, whether the root cause is thyroid or not.”
This Live Well column represents the collaboration between health professionals from the medical staff of our non-profit Intermountain Healthcare hospitals and The Spectrum & Daily News.
