The thyroid is a large gland located at the throat of both men and women. It performs an important role in the endocrine system and is governed by the Thyroid Stimulating Hormone (TSH) released by the pituitary gland.
The thyroid regulates growth, the release of hormones, and plays a crucial role in the aging process of a human body. The hormones secreted by the thyroid also control the metabolism. If a person has trouble with digestion, unexplained exhaustion, starts losing muscle tone, experiences mood swings, or finds sudden changes in their weight, one of the important checks to be made is the thyroid function.
It is a fact that women are more prone to malfunction of the thyroid than men. However, the reason why women are more vulnerable is not known. Women experience a high flux of hormones during pregnancy and again at menopause.
Genetic predisposition is another crucial factor. Of every 5 women with thyroid dysfunction, 1 would have got it as a result of genetic mutation of the TSHB gene. For the most part, abnormal thyroid function is an autoimmune condition.
It is common for thyroid function to be checked at least once in each viable pregnancy, preferably immediately after conception. It also has to be checked at the onset of menopause. The screening involves checks for TSH (Thyroid Stimulating Hormone ) and toT4 to ensure levels are at par with the standards suggested by the American Association of Clinical Endocrinologists and the American Thyroid Association (ATA). The guideline gives basic diagnostic and therapeutic information for Thyroid Nodular Disease, Graves’ disease, Goiter, Hashimoto’s disease.
The most common thyroid issue observed in women is hypothyroidism:
Hypothyroidism is far more rampant than hyperthyroidism. It affects 15-20% of all women over the age of 50. It results from the deficient production of thyroxine and is characterized by sleepiness, tiredness, cold limbs, and digestive disorders like constipation.
The condition is not to be confused with hyperthyroidism, which can occur in women of any age.
Hyperthyroidism is the condition observed by the excessive production of thyroxine. Hyperthyroidism is seen in 1% of women and even less in men. The symptoms of hyperthyroidism can range from having trouble falling asleep to sudden weight loss, irregular menstrual cycles, thinning of the skin, nails, and hair. Increased sweating and heart palpitations are also observed. The symptoms are commonly observed between the ages of 20 and 40.
Thyroid disease is confusing because the symptoms can appear from a variety of causes. Often it goes undetected and undiagnosed in women. For this reason, the ATA recommends women to Screen TSH levels every 5 years after age 35.
A special, regular health checkup is required for women who are experiencing the following conditions:
- Anaemia
- Goitre
- Type 1 diabetes
Pregnant women and women planning a pregnancy should also have a check done for TSH levels on a routine basis.
Treatment of Thyroid Disorder:
Treatment of thyroid disorders is often long-term and is simple and inexpensive. Daily supplementation of Thyroxine is usually recommended for a lifetime. The patient must take the thyroxine tablets daily, on an empty stomach, at the same time of the day.
Apart from medication, there are few more treatment modalities available for hyperthyroidism, which are radioiodine therapy and surgery. The selection of treatment modality depends on patient age, pregnancy, and nature of the disorder.
In some cases, thyroid nodules get swollen up in the thyroid gland. Mostly, these nodules are in benign condition, but sometimes these nodules may be cancer. Hence evaluation of these nodules is important. Investigations like thyroid function test, ultrasound thyroid, and FNAC are recommended. Benign/colloid nodules of small size are monitored for growth and they don’t require surgery. If the tests suggestive of cancer, then the patient requires surgery.
Dr. Raghu MS, Consultant – Endocrinology | Narayana Multispeciality Hospital, Mysore