Exhausted? Gaining Weight? Symptoms of Thyroid Disease
The Testing Controversy
So why aren't all doctors heeding the new guidelines? Some don't think there is enough evidence to support treating people with a TSH level under 5.0, or even under 5.5, says Leonard Wartofsky, MD, a thyroid-disease specialist at the Washington Hospital Center in Washington, D.C., and president of the Endocrine Society. "Are there any large, randomized studies showing that when you bring a TSH level of 4.0 down to 1.5, you miraculously make a person better? No," Dr. Wartofsky says. "Many doctors are unconvinced that treating these patients is going to make a difference, and they're concerned that overtreatment could cause hyperthyroidism [overactive thyroid]. But there are studies showing that when TSH is reduced to a normal level from even a mildly elevated range, symptoms lessen, including the lowering of cholesterol levels and improvement of cardiac function."
Also complicating the issue: The symptoms of hypothyroidism can be associated with so many other conditions. "When faced with vague signs like fatigue, disturbed sleep, and mood changes, a physician may not even be thinking about thyroid disease, but instead considering depression or anxiety," says Wanda Jones, DrPH, director of the Office on Women's Health in Washington, D.C. "Because those symptoms are hard to quantify, it can be difficult for doctors to determine whether treatment will get measurable results. If a woman is having symptoms, she needs to be assertive in requesting testing and discussing treatment."
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