Dr. Allison Peckumn, D.O.
The thyroid is a butterfly-shaped gland that sits at the lower front of your neck, and although it is small, it has the critical role of making thyroid hormones. Your body uses these hormones to manage your metabolism, or how your body uses energy to help control your organs, muscles, heart and brain.
Your immune system works to protect the body from invaders such as bacteria and viruses, but sometimes the immune system mistakes the cells of the thyroid gland for outside invaders and actually attacks them. Over time, an underactive thyroid, or hypothyroidism, can develop when the thyroid is unable to produce adequate thyroid hormones. The primary cause of hypothyroidism in the U.S. is a condition called Hashimoto’s thyroiditis, which is characterized by the production of antibodies to thyroid cells. When these antibodies attack the thyroid, the gland can grow larger, causing a painless swelling in the lower front of the neck called goiter. However, not everyone will develop goiter and only about 10 percent of people with Hashimoto’s thyroiditis will develop hypothyroidism.
Hashimoto’s thyroiditis is most common in women and occurs more frequently with age, but it can happen to anyone. The condition may not produce symptoms for many years, and is often discovered from lab work performed for a routine physical or when your doctor examines your neck. The symptoms of hypothyroidism develop slowly and are very non-specific. They may not be readily recognized and are often attributed to other causes. Fatigue is the most common symptom, but hypothyroidism may also produce dry skin, brittle hair or nails, hair loss, constipation, weight gain, heavy periods, swelling, muscle aches, or memory changes.
Hashimoto’s thyroiditis is thought to be caused by a combination of genetics and possibly environmental factors. The condition often runs in families, so you may be at risk if you or a family member has thyroid or autoimmune issues. Unfortunately, it cannot be prevented or cured, but the hypothyroidism it may cause can be controlled by replacing the thyroid hormone your body is unable to produce. Synthetic thyroid hormone, which acts just like the hormone your body makes, is available in a pill form taken once daily. It is best taken at the same time each day on an empty stomach apart from food, medications and vitamins. Side effects only occur if you are taking too much or too little medication, and your doctor will need to perform periodic lab testing to ensure that your dosage is correct. For those with diagnosed hypothyroidism, taking the medication is very important because untreated hypothyroidism can lead to worsening symptoms, such as elevated cholesterol levels which may increase risk for heart and vascular disease, problems with pregnancy, and very rarely, coma.
Hashimoto’s thyroiditis affects more than 10 million Americans. The hypothyroidism it can cause often goes unrecognized and can interfere with your quality of life, but the condition is treatable once diagnosed. If you suspect you may be at risk for this condition, talk with your physician. He or she can assess you for common signs of hypothyroidism, examine your neck for goiter, and administer a blood test to check for antithyroid antibodies, thyroid hormone levels, and thyroid stimulating hormone (TSH), which stimulates the thyroid to make thyroid hormones. This evaluation will help your doctor make an accurate diagnosis and determine a course of treatment appropriate for you.
Dr. Allison Peckumn, D.O. is an endocrinologist at Banner Good Samaritan Medical Center. For more information, talk with your doctor or call