Exhausted? Gaining Weight? Symptoms of Thyroid Disease
Who Should Get Tested?
While most experts don't recommend regular screening until you reach menopause, if you have a family history of thyroid problems or are experiencing symptoms such as weight gain, fatigue, puffiness, hair loss, depression, dry and itchy skin, and sore muscles, and are baffled as to the cause, you should ask for the blood test, recommends Richard Hellman, MD, president of the AACE. It takes only a few seconds, most insurance companies pay for it, and a laboratory can perform the test in less than 90 minutes. Results should come back within days.
Most important, if you're pregnant or trying to conceive, get your thyroid levels checked as soon as possible, says Dr. Hellman. "To me, it's unconscionable not to do it," he says. Left untreated, even subtle forms of thyroid dysfunction can have devastating consequences for a developing fetus, including miscarriage, premature birth, and developmental problems. In fact, the March of Dimes and other organizations are eagerly awaiting results from research on whether treating pregnant women with mild hypothyroidism will reduce the risk of these complications. If you're already on medication for an underactive thyroid, you'll probably need to have your dosage of thyroid hormone increased during pregnancy to maintain healthy levels. (Thyroid hormone replacement medication is safe to take when you're pregnant.) Here's how you can advocate for your best care:
- Ask for a thyroid screening at your preconception checkup or if you're experiencing unexplained symptoms such as fatigue, unexplained weight gain, dry skin, lack of sleep, joint pain, a diminished sex drive, irregular periods, difficulty conceiving, and difficulty concentrating.
- Quantify your symptoms when describing them to the doctor. Instead of just saying, "I'm gaining weight and not doing anything differently," try something like: "I'm on a 1,800-calorie diet and run five miles three times a week, and I'm still gaining weight. I used to sleep 8 hours a night, but now I need 11, and I'm still waking up exhausted." Make sure to be as specific and tangible as you possibly can.
- If your doctor still doesn't want to test you or tells you that your thyroid levels are considered normal, but you continue to have symptoms, get a second opinion from an endocrinologist. "Primary-care doctors can't be experts in everything," says Dr. Wartofsky. "Endocrinologists are trained in the subtleties of hypothyroidism and other thyroid conditions." To find a specialist near you, go to the AACE Web site at aace.com and click on "Find an Endocrinologist."
Originally published in FITNESS magazine, June 2007.
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