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Are you always tired? Do gain weight easily or have a hard time losing it?

Do you have to wear socks to bed even in the summer?

Are your hair and/or eyebrows thinning?

Do you have chronic constipation?

If you answered yes to any or all of these questions, hypothyroidism may be an issue for you.

Thyroid-related problems — both an under-active or over-active thyroid — can impact your energy levels, fertility, mood, weight, sexual interest and ability to think clearly. Thyroid hormones regulate the metabolism in every cell of the body, and an imbalance of thyroid hormones can affect virtually all body functions.

These hormones are known as T3 & T4 and are produced in the butterfly-shaped thyroid gland, located just below the Adam's apple.

Excessive secretion of thyroid hormones can increase metabolic rate up to 100 percent above normal, while if very little or no thyroid hormone is produced, a 40 percent drop in metabolic activity can quickly occur.

The two conditions that affect the thyroid are hypothyroid (an underactive thyroid) and hyperthyroid (an overactive thyroid). It sometimes takes years for thyroid problems to develop.

Screening test

Measurement of serum TSH is generally considered the best screening test for thyroid disease; increased values usually indicate hypothyroidism, and decreased values usually indicate hyperthyroidism. This test has proven to be both sensitive and specific. Other tests, such as the Free T4, Free T3 and thyroid antibodies have some value in diagnosing 'subclinical' thyroid disease.

The most common form of hypothyroidism is Hashimoto's thyroiditis - an autoimmune disorder where the body is producing antibodies that fight the thyroid and lead to decreased production of thyroid hormones. The most common cause of hyperthyroidism is Graves' disease — this is also an autoimmune disorder, but in Graves' disease, the antibodies stimulate thyroid hormone you produce. Some thyroid disorders occur after or during pregnancy, after viral or bacterial infections or after long periods of stress.

Both hypo- and hyper-thyroidism occurs predominantly in women, beginning at the ages of 30-40. Some cases of Graves' disease have been associated with heavy metals and prescription drugs.

Although there are several causes of hyperthyroidism, most of the symptoms patients experience are the same regardless of the cause. Because the body's metabolism is increased, patients often feel hotter than those around them and can slowly or rapidly lose weight even though they may be eating more.

Other signs and symptoms of hyperthyroidism include: palpitations, insomnia, nervousness, restlessness, difficulty concentrating, frequent bowel movements, goiter (visibly enlarged thyroid gland), increased sweating and irregular menstrual periods in women.

Signs and symptoms of hypothyroidism include fatigue, weakness, weight gain or increased difficulty losing weight, coarse dry hair and skin, hair loss, cold intolerance, constipation, depression, irritability, abnormal menstrual cycles and decreased libido. Many individuals will have a combination of these symptoms associated with hypothyroidism.

Symptoms, severity

The severity of symptoms in adults ranges from extremely mild deficiency states, which are barely recognizable (subclinical hypothyroidism) to severe deficiency states, which are life threatening (myxoedema).

The estimates vary, but approximately 10 million Americans have this common medical condition. In fact, as many as 10 percent of women may have some degree of thyroid hormone deficiency. Women are 10 times more likely to develop a hypothyroid condition in their lifetime than men.

One study showed nearly 6 percent of women over the age of 60 have undiagnosed hypothyroidism. This is mainly due to the fact that menopausal and hypothyroidism symptoms often mimic each other, therefore many women escape the hypothyroidism net and are mis-diagnosed.

The majority of individuals who are diagnosed with hypothyroidism are treated with thyroid replacement hormone. The overall goal is to have the patient take enough thyroid hormone in order to lower the TSH values and increase the free thyroid hormone levels in the blood.

The lab numbers obtained should be correlated with an individual's symptoms to achieve the best possible dosage. The “gold standard” in conventional medicine is replacement therapy with synthetic T4 (Levothyroxine).

Some patients will do very well on this. Others do better with additional T3 (Liothyronine), especially as some people are not able to convert from T4 to T3 and others have cells that don't absorb T3 well.

Another popular option is natural thyroid hormone. This includes Armour, WesThroid and Nature-Throid.

Thyroid hormones, whether endogenous or exogenous, induce many physiological effects and modify virtually every metabolic pathway in our body. They have general rather than specific effects and this is why an imbalance can present with a variety of symptoms.

Krista Brayko, N.D., is a resident physician in naturopathic medicine at Yellowstone Naturopathic Clinic. She can be reached at 259-5096.

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Suzanne Ady can be reached at 657-1482.

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