American Thyroid Association

January is Thyroid Awareness Month. The thyroid is part of the endocrine system, and can be described as the engine that provides the energy your body needs, controlling the speed at which your body operates. The pituitary gland is the gas pedal that tells the thyroid to produce the hormones that fuel the performance of all the cells in your body. When these two glands miscommunicate or misfire, many other systems suffer. Thirty million Americans have some form of thyroid disease, and women between the ages of 25 and 60 are three times more likely than men to develop thyroid cancer. Adults over 65 who develop thyroid problems are often misdiagnosed with other conditions, since the symptoms of thyroid disease often resemble those of other diseases, or simply the signs of aging. Caregivers, home care aides and loved ones need to know the signs and symptoms of thyroid disease, because the body can’t function well without the thyroid.

The thyroid is one of eight glands that comprise the endocrine system, along with the pituitary gland, the adrenal gland and the pancreas. This system affects metabolism, growth, mood, development, and sexual function. All these glands produce hormones, and when production is too high, too low, or not delivered or received as expected, the body can’t perform normally. The thyroid transforms iodine from the bloodstream into two crucial hormones: thyroxine (T4) and triiodothyronine (T3). The thyroid produces mostly T4, and the liver, kidneys and brain turn T4 into T3 by removing one iodine atom. The pituitary gland tells the thyroid when to distribute T4 (and some T3) into the bloodstream and in what amounts by sending it thyroid-stimulating hormone. The pituitary gland controls the activity of all the other glands in the endocrine system, in a hormonal orchestra that runs the human body.

Thyroid diseases, as a group, are more common than diabetes or heart disease, and more than half of the 30 million American estimated to have a thyroid condition are currently undiagnosed. Women are more likely to develop both thyroid cancer and hypothyroidism than men are, and by the year 2020, the number of women with thyroid cancer will double, to reach 70,000 cases. Nearly 20% of women over 60 have a thyroid condition, and hypothyroidism is much more common in those over 65.  In fact, thyroid problems are quite common in older adults, though difficult to detect. The symptoms often mimic the signs of other age-related health problems, and are dismissed or overlooked. Hyperthyroidism and hypothyroidism manifest more subtly in older patients than younger ones, often masked as issues in the bowel, heart or nervous system. A history of thyroid disease in a close family member is one of the best indicators of potential thyroid disease.

Thyroid problems and diseases include goiter, Graves’ disease, thyroid nodules, thyroiditis, toxic adenomas, pituitary gland malfunctions, thyroid cancer, and the most common: hyperthyroidism and hypothyroidism. Hyperthyroidism is most common in patients under age 50, and is marked by an enlarged thyroid gland, plus insomnia, a rapid heart rate, anxiety, weight loss, increased appetite, excessive perspiration, and diarrhea. However, the senior hypothyroidism patient may only have one or two of these symptoms, which can delay or prevent accurate diagnosis. Hypothyroidism is most common is patients over 60, and the incidence of this disease increases with age. The symptoms are non-specific, especially for the older patient, and include fatigue, increased sensitivity to cold, unexplained weight gain, dry skin, joint pain, muscle stiffness, constipation, and depression. And older adults can also suffer memory impairment, weight loss, loss of appetite, and even incontinence. As older patients may only have a handful of these issues, it’s easy to see why hypothyroidism is so under-diagnosed.

Wondering if you or your loved one have a thyroid condition? Test your ‘Thyroid IQ’ by taking this quiz, and check out that neck lump here. Family history, a history of radiation treatment for cancer or acne, and a physical exam are the best ways to test for thyroid conditions. Hypo- and hyperthyroidism can be treated with medication, iodine, or hormones, and the other conditions can be addressed with therapy or surgery. Caregivers and loved ones should know the signs and symptoms of thyroid disease, as it is more common than diabetes or heart disease and woefully under-diagnosed in seniors.