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Do I Have A Thyroid Problem?
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Dr Jeremy Sims mb
bs friph frsh answers the question:
Overweight patients often ask, with great worry in their eyes, whether
a thyroid disorder might be the cause of their weight problem.
I am completely frank in my reply, because there seems to be a common
misconception that such hormone disorders are rife - and in reality,
thyroid diseases are in fact highly uncommon. Indeed, less than a fraction
of 1% of all overweight people have a disorder of the thyroid gland.
However, it is important that we understand how this gland can, in rare
cases, upset the apple cart when it comes to achieving or maintaining a
healthier weight.
Types of Thyroid Disease
The thyroid is an organ in the neck, and in some cases the upper chest,
which produces essential hormones (eg. thyroxine) for controlling the
body's metabolism, amongst other functions. There are three main
categories of thyroid disease characterized by the levels of associated
hormone production - low hormone production, normal production and high
production.
The first category, a state known as hypothyroidism (literally
"Under-Active Thyroid") is the one that we are concerned with
here - since low thyroid hormone production, and therefore slowed
metabolism, can have considerable implications for weight management.
Hypothyroidism - The Causes
Hypothyroidism may be caused not only by a disorder of the thyroid
gland itself, but also by a variety of diseases that affect the
hypothalamus and pituitary gland. Hashimoto's disease, also known as
chronic lymphocytic thyroiditis (an inflammation of the thyroid) is the
most common cause in the UK.
An iodine deficient diet, now thankfully very rare in the UK following
inclusion of iodine in table salt, can also cause hypothyroidism, as can
surgery and a certain number of drugs (eg. lithium, phenylbutazone).
Hypothyroidism may also be evident at birth, the congenital form of the
disorder. Finally, the so-called idiopathic (cause unknown) hypothyroidism
is now strongly believed to be a disease of the immune system and may be
associated with underactivity of the other endocrine organs and glands, as
well as immune disorders such as systemic lupus, erythematosis and
rheumatoid arthritis.
Hypothyroidism and Weight Gain
As mentioned, hypothyroidism slows down the metabolism and consequently
may cause weight gain. Remember, if you experience symptoms including
unusual and unexpected weight gain, arrange a blood test with your doctor.
If hypothyroidism is diagnosed and corrected (eg. with medication) your
metabolic rate and weight level should return to normal in a reasonable
short period of time.
Hypothyroidism and Weight Loss
However, be warned, in a very few number of cases, even whilst on
medication, overweight people with hypothyroidism may experience
difficulty with weight loss. In such cases it is very important to pay
particularly close attention to diet and exercise - in addition to
ensuring the correct dose of medication is being taken. This strategy will
often prove effective in helping these people to lose weight. Indeed, it
has been revealed through extensive research that exercise is especially
important for weight loss amongst sufferers of hypothyroidism.
Hypothyroidism - Typical Symptoms
The symptoms of adult onset hypothyroidism result from an overall
slowing of body metabolism. The onset is usually gradual and, in most
instances, the person may not recognize the early signs and symptoms which
include: fatigue, lack of energy, intolerance of cold temperatures,
constipation, heavy menstrual periods, and weight gain despite a
diminishing appetite.
Hypothyroidism - How It Is Diagnosed
Hypothyroidism is often not diagnosed in the early stages because the
signs and symptoms in adults are initially nonspecific. But an alert
physician will always consider it in cases of chronic or unusual fatigue,
unusual weight gain, obesity, constipation and dry skin.
Hypothyroidism - The Treatment
Medical treatment is most commonly an orally administered, synthetic
preparation of L-thryoxine. In order not to "shock" the system
or aggravate co-existing heart disease in older persons, the drug is first
administered in small doses and gradually increased individually by
regular measurements of blood hormone levels.
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