Thyroid disease, a silent menace

[Guest guest]

Oprah had it, and so could you. Millions of Americans suffer from the

disease, which often goes undiagnosed.

 

By Mary Beckman

Special to The Times

http://www.latimes. com/features/ health/la- he-closer24sep24 ,1,4585413. story

 

September 24, 2007

 

Oprah Winfrey recently informed the nation on " Good Morning America " that

she " blew out her thyroid " at the end of last season because of stress.

But that isn't exactly a medical term. No one blows out a thyroid, says

endocrinologist Dr. Terry Smith of Harbor-UCLA Medical Center. " What is

that? Like a right rear tire on a Ferrari? " he asks.

 

Winfrey then wrote about her medical condition in the October issue of her

magazine, O, elaborating that she had both kinds of thyroid disease -- an

overactive thyroid and then an underactive one, both considered autoimmune

diseases.

 

The American Assn. of Clinical Endocrinologists estimates that about 27

million Americans have one of these problems, more than half of whom don't

realize it. Possibly because of reproductive hormones or other still

unknown reasons, women get autoimmune diseases more often then men, and

about four times more women than men get thyroid disease.

 

Stress affects the immune system, but can stress spark an autoimmune

disease that damages or impairs the thyroid gland?

 

The thyroid is a small gland at the base of the neck above the collarbone

(it's what swells in people with goiters). The gland pumps out two main

thyroid hormones, called T3 and T4, which regulate metabolism. " Every

single tissue needs thyroid hormone, " says endocrinologist Dr. Peter

Singer of USC's Keck School of Medicine.

 

Thyroid disease begins when the body starts to make antibodies to attack

the gland's healthy tissue. Researchers have a variety of theories about

why this happens. One theory is that when the immune system fights off

bacteria from an infection, it inadvertently harms the thyroid as well.

 

The type of thyroid disease that develops depends on the kinds of

antibodies made, and inherited genes partly determine that.

 

Some people begin to make antibodies that stimulate the gland to

overproduce thyroid hormones. Pregnancy or stress, such as what a

celebrity might experience, can in fact instigate this.

 

" Potent physical or emotional stress can cause an overactive thyroid in

those people who have the underlying genetic background, " says Singer.

 

Too much thyroid hormone speeds up metabolism. People lose weight, their

heart beats rapidly, they have palpitations. " It feels like you're amped

up, " says Singer. " You've got all the symptoms of being in love. " Although

the thyroid gland might slow down on its own, doctors usually treat the

condition before that happens.

 

An obvious symptom of an overactive thyroid is a bulging of the eyes

because the tissue behind them have become inflamed, pushing on the back

of the eyeballs. " There are about 100,000 people or so who walk around

with bulging eyes, " says Smith. Some experience double vision and, in

serious but rare cases, people can go blind. Smith and colleagues are

developing a therapy that blocks the inflammation in that tissue.

 

People with overactive thyroids are treated with medications or

radioactive iodine that kills off part of the thyroid, or surgery that

snips out part or all of the gland. After any of these regimens,

overactive-thyroid patients usually have to go on the same drugs that

underactive- thyroid patients take.

 

Underactive thyroid is far more common than the overactive kind and occurs

when the autoimmune antibodies destroy thyroid tissue. It hits middle-aged

men and women. " At Oprah's age, [53] about 6 to 7% of women have it, " says

Singer. People who have low thyroid levels feel sluggish, as if they're

not running on all cylinders. Also, they gain weight. " They gain no more

than about 10% of their baseline weight, " says Singer. " As their

metabolism slows, so does their appetite. "

 

They can also have dry skin and hair, depression and other symptoms.

Patients are treated with medications that replace the lost hormones.

 

To check for thyroid disease, doctors do a simple blood test that measures

the amount of T3 and T4 as well as thyroid-stimulating hormone, which

prods the thyroid into making T3 and T4 in the first place.

 

The ratio of the three hormones to each other reveals whether the thyroid

is over- or underactive. Sometimes physicians will first test for T4, the

main hormone, then test again if it is abnormal.

 

The American Thyroid Assn. recommends that everyone over 35 get tested for

thyroid function because the diseases so often go undiagnosed. Winfrey was

long overdue.

 

 

Take the Internet to Go: Go puts the Internet in your pocket: mail, news,

photos & more.