Dr. Friedman Discusses if patients with symptoms of hypothyroidism, who don't meet the criteria, be watched every six months to year?
THE UNDERACTIVE THYROID
As your thyroid begins to fail, you may feel perfectly well, for often the only suggestion of a problem will be a slight enlargement of your thyroid gland (goiter), appearing as a lump or swelling in front of your neck. Then, as your thyroid hormone level falls further, you may begin to feel tired and listless, perhaps chilly when those about you are comfortably warm. As your skin, hair, and fingernails grow more slowly, they become thickened, dry, and brittle. Some hair loss may be noticed. Then, as your hypothyroidism becomes more severe, changes may occur in the tissues beneath your skin that lead to a characteristic puffy, swollen appearance known as myxedema. This is often particularly apparent around your face and eyes.
Your circulation is affected and your heart rate slows, but you probably won't notice this unless someone happens to count your pulse (it may be below 60 beats per minute). Since your intestinal activity slows down, you may become constipated. A few pounds of weight gain may occur due to water retention, but you are not likely to get fat due to hypothyroidism alone because your appetite and zest for food decrease rather than increase when you become hypothyroid. Your muscles may become sore and you may be awakened at night with leg cramps. Muscle swelling may occur and may make your tongue (which is a muscle) bigger. Your nervous system may be affected in several ways. You may notice some memory loss, decreased ability to think, depression, and you may become more sensitive to medications, so that weak sedatives cause prolonged sleep. Some patients experience tingling in their fingers, or loss of balance and difficulty in walking.
If you are a younger woman, changes in your reproductive system may cause longer, heavier, and more frequent menstruation. Your ovaries may stop producing an egg each month, and, if so, it may be difficult for you to get pregnant. If pregnancy does occur, you are a little more likely to have a miscarriage than if you had a healthy thyroid.
MORE ON DR. FRIEDMAN
Theodore C. Friedman, M.D., Ph.D. has opened a private practice, specializing in treating patients with adrenal, pituitary, thyroid and fatigue disorders. Dr. Friedman has privileges at Cedars-Sinai Medical Center and Martin Luther King Medical Center. His practice includes detecting and treating hormone imbalances, including hormone replacement therapy. Dr. Friedman is also an expert in diagnosing and treating pituitary disorders, including Cushings disease and syndrome.
Dr. Friedman's career reflects his ongoing quest to better understand and treat endocrine problems. With both medical and research doctoral degrees, he has conducted studies and cared for patients at some of the country's most prestigious institutions, including the University of Michigan, the National Institutes of Health, Cedars-Sinai Medical Center, and UCLA's Charles Drew University of Medicine and Science.