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What you should know about thyroid disease

Created date

December 21st, 2009

Jack has been taking extra naps lately and gaining some weight. Mary has been feeling weak, especially in her legs when she climbs stairs. Nancy has slowly lost her appetite and occasionally feels fluttering in her chest. All of these people have something in common: thyroid disease. Thyroid disease becomes more prevalent as people age, says Susan Reeder, M.D. It s also more common in women and in people who have it in their family history. Your thyroid gland is small, shaped like a bow tie, and located just above your collarbone. It produces hormones that regulate the rate at which your body carries out its necessary functions. The most common thyroid diseases are hyperthyroidism (an overactive thyroid) and hypothyroidism (an underactive thyroid). Both conditions can have similar symptoms.

Hyperthyroidism

Hyperthyroidism occurs when too much thyroid hormone is produced. This, in turn, causes bodily functions to speed up. A common cause of hyperthyroidism in older adults is a goiter or enlarged thyroid gland, says Sally M. Pinkstaff, M.D., endocrinologist and geriatric specialist at Sinai Hospital in Baltimore, Md. Sometimes the goiter produces too much thyroid hormone. Older adults may only have one or two symptoms of an overactive thyroid, like heart palpitations or weight loss. Other symptoms can be difficulty sleeping, tremors in the hands, weakness, or diarrhea. Treatment for hyperthyroidism may involve antithyroid medication or radioactive iodine treatment (a one-time pill), depending on your doctor s recommendations. Surgery may be an option, depending on your health. People successfully treated for an overactive thyroid sometimes develop an underactive one.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland stops producing enough thyroid hormone. By age 60, as many as 17% of women and 9% of men have an underactive thyroid. Hypothyroidism is treated by taking the thyroid hormone in pill form. The symptoms of hypothyroidism may not be obvious. People with hypothyroidism may have vague symptoms like fatigue, dry skin, weakness, weight gain, or depression, Reeder says. Hypothyroidism s onset can be so gradual, people may barely notice the symptoms, Pinkstaff adds.

Thyroid disease and other health conditions

It s important to treat a malfunctioning thyroid, Reeder says. Thyroid disease can affect your heart and cholesterol levels. It may contribute to anemia or depression. Pinkstaff adds, With hyperthyroidism, osteoporosis can worsen. And if your muscles are weak, you can be at an increased risk for falls.

Important medication considerations

Medications for hyperthyroidism, likepropylthiouracil (no brand name available) ormethimazole(Tapazole or Northyx) may have a mild suppressive effect on your immune system, Reeder says. Tell your doctor if you develop any signs of infection like a fever or sore throat. Levothyroxine(Synthroid, Levothyroid, or Levoxyl) is commonly prescribed for hypothyroidism. Getting the dosage right is important so you may need lab work periodically to check your blood levels, Reeder says. And tell your doctor about any other medications you are taking. Antacids, or other medications that change the acid balance in your stomach, can affect the waylevothyroxine is absorbed. Some foods, like soy products and high-fiber foods, may also affect absorption.

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