Debate Over Thyroid Testing
Millions of Americans suffer from underactive thyroid glands, and most don't even know it can cause a variety of health problems. Proper testing has long been deemed the key to getting the right treatment.
But, reports The Early Show medical correspondent Dr. Emily Senay, there is some debate in the medical community about the accuracy of those tests and their importance in diagnosing thyroid problems.
The thyroid, Senay explains, sits in the front of the throat, a butterfly-shaped gland just below the Adam's apple. It secretes hormones that regulate growth and the way the body uses energy.
Problems usually result when the gland isn't producing enough of the hormone, a condition known as hypothyroidism.
Hormone fluctuations can happen during pregnancy or menopause, or be caused by infections and some medications. Some people are born with an underactive thyroid.
The most common thyroid disease, Senay continues, is an immune system disorder linked to aging, in which the body destroys its own thyroid cells and the lack of the hormones causes a body-wide slowdown. Older women, especially, are more prone to this kind of thyroid problem, but not everyone will automatically develop thyroid disease just because they get older.
Symptoms of thyroid problems can include memory lapses, depression, fatigue, feeling chilled or increased sensitivity to cold, weight gain or trouble losing weight, high cholesterol, thinning hair, dry skin and puffy eyes.
Many of those symptoms may also be symptoms of other problems, so you really need to see a doctor for a diagnosis.
Underactive thyroid is diagnosed by blood test, and can be treated by prescribing thyroid hormone.
It's important to talk to your doctor about a test for thyroid disease if you suspect you may be suffering from it, Senay emphasizes.
Many doctors reacted with concern to opinions expressed during an interview on The Early Show last month in which Dr. Steven Hotze cast some doubt on the effectiveness of the standard blood tests for thyroid disease for use in making a decision on whether to treat with thyroid hormone.Hotze said that, by the time a woman is 50, her thyroid function could well have decreased by 50 percent, leaving her exhausted, depressed, and wondering how she's going to make it through her day. But her thyroid lab tests may read normal.
"Since thyroid hormones enable your cells to generate energy," he writes in his book, "Hormones, Health, and Happiness," "is it any wonder that as your thyroid hormone level declines, your energy level also decreases? If a doctor relied solely on a lab test to evaluate your thyroid function, he would tell you that your condition is 'normal' — but you wouldn't feel normal with 50 percent less thyroid hormone. To ensure that you have plenty of energy and feel healthy, your doctor should strive to maintain your thyroid hormone level in the range that is optimal for you."
He told The Early Show co-anchor Rene Syler, "In my opinion — and the way we treat it at our center in Houston, Texas, and I write about it in the book — we listen to the patient and let her tell us her symptoms. And then we will treat her based upon her clinical symptoms and give her a therapeutic trial of thyroids."
Dr. Lawrence Wood, of the Thyroid Foundation of America counters that, expressing the accepted view in the medical community that proper testing is absolutely necessary because thyroid hormone can be very dangerous if it's not used correctly.
"If you take too much thyroid and you have a heart condition," Wood said, "you could have a heart attack or a dangerous heart arrhythmia, so we just don't treat people who don't need thyroid hormone.
"Thyroid diagnosis is not a vague business. It's precise. We can make the diagnosis. Your doctor can tell if you need thyroid hormone. We want you to have it if you need it. We want you to be tested for it if there's a good reason, but we never want you to take thyroid hormone without proper testing."
The bottom line here, Senay stresses, is that you shouldn't make any decision to use thyroid hormone until you see a doctor first.
Click here to read an excerpt of "Hormones, Health and Happiness."