Thyroid For Dummies
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Thanks to the Internet, you have access to incredible amounts of information about your thyroid. Unfortunately, much (perhaps most) of it is not accurate. Much of what you read online is based on the experiences and opinions of one or a few people who took this or that medicine or herb and got better in two weeks. Maintaining a healthy degree of skepticism is important.

Here are a few misconceptions — and myth-busting facts — that may help you understand the real deal behind the little gland with the big reputation.

I'm hypothyroid, so I can't lose weight

If you have hypothyroidism, or if you've been treated for a thyroid condition and the cure resulted in your becoming hypothyroid, you may find that you have a hard time losing weight. The myth is that you can't lose weight if you have hypothyroidism, even when it's properly treated.

The truth is that a large percentage of people who are being successfully treated for hypothyroidism weigh almost the same after being treated as they did before they developed the disease.

Keep in mind that hypothyroidism is associated with fatigue. Many patients with hypothyroidism reduce their physical activity as a result. They may not restore their previous level of activity after the hypothyroidism is treated properly.

The bottom line is that we all follow the principle of conservation of energy. If we take in too much energy compared to what we need, we gain weight. If we take in too little energy compared to what we need, we lose weight.

Another truth is that our metabolic rate declines, as does our tendency to move around, as we age. Both changes tend to make weight loss more difficult, but it's still possible.

I'm hyperthyroid, so I can't gain weight

The myth that hyperthyroidism is always accompanied by weight loss is a source of confusion in making an accurate diagnosis. Although the majority of patients do lose weight when they become hyperthyroid, some patients actually gain weight — the elderly, in particular.

Weight loss, as well as other symptoms of hyperthyroidism, may not always be present, especially in the elderly population. The best solution is to get thyroid blood tests every five years, beginning at age 35.

I have to take thyroid medication for life

Many patients are told that once they are on thyroid hormone replacement, they'll be taking it for life. For many people, this is true. Any treatment that removes or destroys much of the thyroid (such as surgery or radioactive iodine) will require treatment with thyroxine (T4 hormone) for life. However, in certain situations, hypothyroidism is temporary; you may need thyroxine for a time, but you will later stop taking it. Sometimes it may be obvious that you no longer need the medication, but other times you and your doctor may need to attempt a trial period off thyroid for 4 to 6 weeks to see if you still need it.

The following are some of the conditions that require thyroid hormone replacement for a limited amount of time.

  • Subacute thyroiditis causes the temporary breakdown of thyroid cells and the release of thyroxine from the thyroid. As this condition improves, thyroxine begins to be made and stored again, and oral thyroxine is no longer necessary.
  • Silent and postpartum thyroiditis also cause temporary loss of thyroxine, which is restored with time.
  • Acute thyroiditis occasionally requires temporary treatment with thyroid hormone.

Depending on your diagnosis, you may be able to stop thyroid hormone treatment at some point. It's well worth checking, particularly if you are young (under 40).

Thyroid disease is catching

It's not hard to understand why this myth became so entrenched in the minds of the public. Most thyroid disease is inherited; so the likelihood of finding the same disease in two sisters or a mother and her daughter is relatively high, suggesting that their physical closeness to one another causes them to have the same disease. Furthermore, in areas where people don't consume enough iodine, practically everyone has thyroid disease — again suggesting that it may develop.

Another situation that seems to suggest that thyroid disease is catching is the occurrence of thyroid disease after large-scale radiation exposure. Just about everyone comes down with some illness in that situation. Children, especially, often develop goiters, nodules, and thyroid cancers.

An understanding of the way these diseases develop quickly clarifies the situation:

  • The hereditary thyroid diseases affect the females of a family, usually sparing the males.
  • After iodine is supplied, the incidence of thyroid disease rapidly declines in iodine-deficient areas.
  • Children who take iodine pills or avoid exposure to radioactive iodine generally will not get thyroid diseases, while those who do not, will.

You cannot catch thyroid disease, nor can you give it to someone else in the way that germs are passed from person to person.

Iodine deficiency is a medical problem

Because iodine deficiency causes hypothyroidism, goiter, and cretinism (when severe), you would think that it's a clear-cut disease that should respond to medical treatment with iodine. If this were so, the disease would have disappeared years ago.

As with any major medical problem (like AIDS, breast cancer, and prostate cancer), iodine deficiency is a social, economic, and political problem as much as, or more than, it is a medical problem.

To begin with, an understanding about the cause of hypothyroidism in iodine-deficient areas is often lacking. The people are poor, work very hard, and have little time for the intricacies of the cause of disease. Their poverty means that they cannot afford to pay for nurses to give them medication or inject them with iodized oil. They do not understand that certain foods, like cassava, worsen the problem, so they continue to consume large quantities of them.

Sometimes, attempts to solve the problem run up against the realities of salt production. This has been the case in Indonesia, for example, where salt is made by numerous salt farmers rather than a centralized salt production facility (as is done in China). It was easier and more productive to alter the salt production to make enough iodized salt in China than it was in Indonesia.

The instability of poor governments also plays a role. When the problem of iodine deficiency was recognized in Communist East Germany, iodine was provided and the disease was brought under fairly good control. After the reunification of East and West Germany, the combined government neglected the problem, and iodine deficiency began to reappear.

The solution to a clearly medical problem like iodine deficiency may have to involve social, cultural, and economic changes that populations often resist, making a cure exceedingly difficult.

About This Article

This article is from the book:

About the book author:

Alan L. Rubin, MD, has had a private practice specializing in thyroid disorders and diabetes for nearly three decades. A member of the Endocrine Society, he speaks regularly on thyroid health.

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