Hypothyroidism

Hypothyroidism is 4 to 8 times more common in women, more likely with family history of autoimmune disease, affects 10-20% of women over 50 in the general population, is more common in the elderly, and often misattributed to menopause and aging.

Hypothyroidism affects all cells in the body and the symptoms tend to worsen over time.

Thyroid disease can contribute to menstrual disorders, particularly to heavier periods. Infertility is common in untreated hypothyroidism, and pregnancy management is an important issue if one had thyroid disease.

Treatment of hypothyroidism consists of replacement therapy. Treatment choices include desiccated thyroid or Levothyroxine. Desiccated Thyroid is made from desiccated (ground-up) pig thyroids. The amount of thyroid can vary greatly from batch to batch. Levothyroxine (Synthroid, Levoxyl, Levothroid and other brands) is synthesized in the laboratory. It contains a fixed amount of Levothyroxine (T4). This is one of the hormones your thyroid gland makes. Using Levothyroxine tends to be more accurate than with desiccated thyroid.

Side effects of over-treatment (getting too much thyroid hormone) include an increased risk of osteoporosis and an increased risk of irregular heart rhythm, known as atrial fibrillation.

Because absorption can vary from brand to brand, once you start on one brand, it is best to stay with the same brand. Or if you switch, blood tests can be taken to see of levels are still in range (6-8 weeks after change).

Hyperthyroidism

Graves disease is a condition in which the body makes antibodies that "trick" the thyroid into thinking it needs to continue making excessive amounts of thyroid hormone. Graves Disease can sometimes result in hypothyroidism due to thyroid destructive therapies or the natural history of the disease itself.

Common symptoms of Graves Disease are outlined as follows:

The best laboratory test to diagnose an overactive thyroid is the TSH (thyroid stimulation hormone). The normal range is usually .5 to 5. A low value would suggest you need more tests to confirm that your thyroid is underactive.

Hyperthyroidism can be treated in several ways, including antithyroid agents, radioactive iodine, surgery, and iodine (temporary measure only).

If you are diagnosed with hyperthyroidism, ask your doctor to refer you to a board-certified endocrinologist to help you determine which treatment is best for you.

Implications between the Association of Sprue and Thyroid Disease

You and your doctor should have a lower threshold for testing for thyroid disease in people with sprue. If you have sprue and an underactive thyroid, you need to be concerned about thyroid hormone absorption. If your sprue is not adequately treated (resulting in malabsorption), you will not absorb all of your thyroid hormone and your condition will worsen.

With regard to an overactive thyroid, the symptoms may be confusion and may mimic sprue (particularly, increased bowel movements and weight loss).

Osteoporosis and Sprue

While not necessarily related to thyroid disease, osteoporosis is another endocrine disorder for which persons with sprue are at risk. Persons with undiagnosed sprue for a long time have a greater risk for osteoporosis because of poor calcium and vitamin D absorption intake. Vitamin D is obtained through intestinal absorption and through sun exposure. Its role is to increase intestinal calcium absorption. Calcium is important for normal bone mineralization.

A DEXA bone density measurement may be appropriate for persons with sprue, particularly if sprue was untreated for long periods of time. Since osteoporosis is more common in women than in men, all women with sprue should have a bone density test at menopause, or earlier if you have experienced fractures or loss of height.