Thyroid Disease in Women

The thyroid, a small bi-lobed gland seated at the base of the neck, turns out to be a very important little piece of tissue…you might not realize all that this gland does to enhance your health...until it malfunctions. For women, a malfunctioning thyroid is not an uncommon problem and can occur near a pregnancy or at any time in her life. The thyroid gland makes two forms of thyroid hormone: T3 and T4. If the levels are not in balance, the effects can be felt in many different areas of the body.

The basic function of this gland is that of metabolic control, so weight loss or weight gain can result depending upon whether the gland is over-functioning or under-functioning respectively. For some, glandular malfunction can result from the thyroid forming antibodies against itself (autoimmune disease), and women with diabetes might be more at risk for that.

When the thyroid forms antibodies and attacks the gland, inflammation occurs (thyroiditis). The most common type of thyroiditis is called Hashimoto's disease where antibodies damage the gland and cause it to enlarge in response to form a goiter. Hypothyroidism also can result from a diet that does not have enough iodine, but in the US, this cause of low-functioning thyroid is not common.

The symptoms of thyroid disease depend upon whether the levels of the hormone are too high or too low. For generalized glandular enlargement due to a goiter or multiple nodules, a person could notice difficulty with swallowing in addition to the other effects of a malfunctioning thyroid. For hypothyroidism (thyroid hormone levels are too low), the symptoms can easily be missed because they are so common in women. These include weight gain, constipation, fatigue, depressed mood, hair loss, and dry skin and sensitivity to cold temperatures to name a few. For over-functioning gland activity (hyperthyroidism), there can be weight loss, rapid heart rate, loose stools, sweating or hot flushes, menstrual changes and many other potential symptoms.

Diagnosis of thyroid problems is easily accomplished with blood testing for the hormone levels. Also, if a health care provider detects a nodule or goiter on physical exam, an ultrasound or nuclear scan of the thyroid gland can be done to further investigate.

Treatment for low thyroid function consists of medication to try to replace the component of hormone that is missing. The dosage varies with the individual and must be adjusted fairly frequently at first by following blood levels. Once a good blood level is noted, the testing can be decreased to annual checks.

For hyperthyroid disease (Graves disease is the most common cause of this), a medication to block thyroid hormone can be used. Some women will require more aggressive treatment with radioactive iodine to destroy parts of the gland or even surgical removal of the gland.

If the doctor detects a thyroid nodule (a small lumpy growth), cancer must be ruled out and a biopsy may need to be done to determine benign versus malignant origins of the nodule.

Women over age 50 may be more prone to developing thyroid disease and some doctors advocate screening blood tests at least every 5 years to check. Younger women can also be screened as part of their routine exams especially if they have any symptoms that might be attributed to this common, treatable condition.