Q and A: Women and thyroid disease

I recently read that thyroid issues affect women more often than men. Can you explain what the thyroid is and how it affects my body? Can I do anything to prevent having issues with my thyroid as I age?

ANSWER: The thyroid is a small butterfly-shaped gland located at the base of the neck. The thyroid has a significant impact on the body because it produces hormones that help regulate many of your body's functions.

The thyroid gland produces two main hormones: thyroxine, or T4, and triiodothyronine, or T3. These hormones keep your body's metabolism of fats and carbohydrates consistent, aid in maintaining your body's temperature, have an impact on how well your nervous system functions, and can affect your heart rate. A third hormone, known as calcitonin, which aids in controlling the level of calcium in your blood, also is produced by your thyroid gland.

Unfortunately, there are numerous disorders that can affect the thyroid, and women are at higher risk for thyroid issues than men. About 1 in every 8 women will suffer from thyroid illness during her lifetime, according to the American Thyroid Association.

Although it is believed that the development of thyroid illness is connected to a person's autoimmune system, it is not known why women are more susceptible than men to thyroid disease. Genetics may play a role. Women of any age can experience thyroid issues, although women who have just given birth or are going through menopause are more likely to experience thyroid concerns.

Here is information about four of the most common thyroid conditions:

• Thyroid nodules: It's estimated that about half the population in the U.S. will have a thyroid nodule by the time they are 60. Although some may grow to a size where they are visible, frequently these nodules will go undetected until a routine medical examination. Fortunately, most thyroid nodules are benign, but a workup is necessary to determine whether thyroid cancer may be present. Evaluation of a suspected nodule may include a blood test and an ultrasound.
• Hyperthyroidism: When the thyroid gland makes too much thyroid hormone, a condition known as hyperthyroidism, or overactive thyroid, can occur. Sometimes benign nodules can cause an increase in hormones. Hyperthyroidism accelerates the body's metabolism, causing a variety of symptoms. These may include unexpected weight loss; increased hunger; a rapid or irregular pulse; sweating; mood issues, such as increased anxiety or irritation; and changes in menstrual cycle. Depending on a person's age and health history, treatment options may include medication to reduce hormone levels or shrink the thyroid gland. Additionally, some patients may be eligible for surgery to remove all or part of the thyroid.
• Hypothyroidism: When the thyroid gland does not make enough thyroid hormone, hypothyroidism, or underactive thyroid, can occur. There may not be noticeable symptoms of this condition in the early stages, as symptoms often develop slowly or are attributed to other ailments. For instance, many patients report fatigue and weight gain. As the metabolism continues to slow, however, other symptoms may occur, including constipation, raspy voice, muscular weakness and sensitivity to cold. Treatment for hypothyroidism usually involves taking a thyroid medication known as levothyroxine to return hormone levels to a normal level.
• Hashimoto's disease: Hashimoto's disease, or chronic autoimmune thyroiditis, is an autoimmune disorder that occurs when immune system cells lead to the death of the thyroid's hormone-producing cells, resulting in hypothyroidism. Although anyone can develop Hashimoto's disease, it is most common among middle-aged women. The primary treatment is thyroid hormone replacement.

There is no way to prevent thyroid disease. The best course of action is to establish a routine to get annual health physicals and be aware of any symptoms you experience that are unusual. Speak with your health care team about your thyroid health, including the need for tests for thyroid hormone if you are concerned. If you are suspected to have thyroid issues, an evaluation by a thyroid expert or thyroid disorders clinic may be warranted. Overall, most people with thyroid disease can go on to live a normal life.

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