Getting to grips with thyroid health – why is it so important?

What is the thyroid?

The thyroid is a butterfly-shaped gland located in the front of the neck wrapped around the windpipe, and it is responsible for making hormones that are important for different systems in the body to function properly.One of the hormones that are produced by the thyroid is thyroxine (T4). The right amount of T4 in your blood is essential to support your body’s digestion, heart and muscle function, brain development, bone upkeep, and also to ensure that other organs are working as they should.

Types of thyroid disease

There are two main types of thyroid disease. When the thyroid is overactive and makes too much thyroid hormone this can result in a condition called hyperthyroidism, and when the thyroid is under-active, too little thyroid hormone is made and this is called hypothyroidism. Hypothyroidism most commonly occurs due to autoimmune damage of the thyroid gland, however it can also arise as a consequence of iodine deficiency or exposure to radiation, among other causes.

What are the symptoms of hypothyroidism?

Signs and symptoms of an underactive thyroid usually develop slowly, and mild symptoms are mostly ignored until the symptoms become unbearable. Dr Sindeep Bhana, Head of Endocrinology at Chris Hani Baragwanath Hospital and a specialist in thyroid disease, says: “There are a number of symptoms associated with thyroid disease which can easily be overlooked or confused with other conditions.”

Dr Bhana lists some of the symptoms associated with hypothyroidism as being feelings of fatigue with no obvious cause, abnormal menstrual periods, weight gain of five to ten kilograms despite a healthy lifestyle, and thin or brittle hair or fingernails.Other symptoms of an underactive thyroid include sadness, mood swings and depression, irritability, muscle and joint pain, constipation, hair loss and fertility problems. According to Dr Bhana, the loss of the outer third of the eyebrows, particularly in women, is the only symptom that is specific to thyroid disease.

If you are experiencing any number of these symptoms that are associated with hypothyroidism, it’s time to get yourself tested to find out how well your thyroid gland is functioning! The best way to find out is to have a TSH (thyroid stimulating hormone) blood test.

What is a TSH test?

The role of TSH is similar to that of the conductor of an orchestra in that TSH controls the amount of T4 that is produced by the thyroid gland. Changes in blood TSH levels can be a sign that T4 levels are too high or too low; high TSH indicates that the thyroid gland is not making enough T4 (hypothyroidism), and low TSH may indicate that too much T4 is being produced (hyperthyroidism). In most healthy individuals, a normal TSH value means that the thyroid is functioning properly.

Who is at risk of developing hypothyroidism?

Thyroid disease is a common health problem and can affect anyone,  although hypothyroidism more commonly occurs in women and with increasing age. In Dr Bhana’s research experience, approximately 4% of the South African population suffers from hypothyroidism and he estimates that at least half of these cases remain undiagnosed. Furthermore, people of Indian origin have the highest prevalence of hypothyroidism, followed by Caucasians; however, Dr Bhana does caution that hypothyroidism is also a health concern in people of mixed race and African descent. In particular, he strongly recommends a TSH test for:

• Young women experiencing menstrual problems, or a history of miscarriage or not falling pregnant
• Children who are not growing and who are falling behind in school
• The person with a goitre – a fullness in the neck that is a sign of an enlarged thyroid – who has a family history of thyroid disease.

High TSH levels – what now?

When diagnosed with hypothyroidism, there are cost-effective and easily accessible thyroid hormone replacement medicines such as levothyroxine that can be taken as a daily treatment. Levothyroxine starts to work straight away but it can take a few weeks before symptoms get better, even when someone is taking their medication in the proper manner as explained to them by their doctor or pharmacist.

It is important that there is good communication between you and your doctor. A relationship of mutual respect wherein honest discussions can take place and feelings can be shared is ideal for agreeing on the right goals of treatment and care, and these factors ultimately lead to better treatment outcomes.

Remember to share information about your general wellbeing, symptoms, and any other health issues with your doctor.