A brief overview of thyroid disorders in women
Certain disease have a predilection for affecting women and thyroid disorders rank prime amongst them other than gynaecological disorders(obviously).
Thyroid disorders are one of the commonest causes of poor health in women and nearly 3-5% of women are affected by this disorder at any time.
Disorders of thyroid gland may manifest as either hormone excess or hormone deficit. Since features of lack of hormones are more common in women we will discuss this this detail here.
Here is a brief about the function of thyroid gland before we proceed further. The thyroid gland is a shield shaped gland located in the neck over the Adam’s apple. It produces a hormone Thyroxine which is essential for maintaining the body’s metabolism. Lack of this hormone leeds to slowing down of body metabolism and this cause various symptoms. Excess of thyroxine on the contrary will cause increase in metabolism leading to a different set of problems.
HypothyroidismHypothyroidism is the name given to a cluster of symptoms and signs which develop in thyroid hormone deficiency (remember hypo means less and hyper means more in medicine).
The thyroid gland is most commonly damaged by infiltration of the glad with white blood cells. The reasons for this self destruction are not known but the destruction of thyroid goes by the name of Hashimoto’s thyroiditis.
The deficiency of thyroid hormone causes generalised slowing of metabolism in the body. It commonly presents as lethargy, cold intolerance, weight gain, thick dry skin, hoarseness of voice and general slowness of mentation.
Women also present with constipation and amenorrhoea (absent periods). The other signs and symptoms of hypothyroidism include infertility, recurrent abortions and discharge of milk from the non lactating breasts.
So if you have put on weight rapidly and suffer from any of the above symptoms you should consult a doctor and get your thyroid hormone levels checked.
Diagnosis of Hypothyroidism is done on the basis of a thyroid hormone assay. Levels less than cut off values are taken as diagnostic of hypothyroidism.
Hypothyroidism is easily curable. Since hypothyroidism is caused by a lack of thyroxine, replenishment of thyroxine will alleviate all feature of this disease. Thyroid hormones come as convenient tablets and they are generally taken at the dose of half a tab to one and half tablets before breakfast every day.
Women with hypothyroidism will need to take thyroid replacements for the rest of their lives.
Hyperthyroidism
Hyperthyroidism refers to the syndrome produced due to excess thyroid hormones. As mentioned before thyroid is vital to maintain body metabolism. Excess thyroid hormone increases body metabolism and causes weight loss. Apart from weight loss patients also complain of irritability, nervousness, tremulousness, poor sleep, loose motions and heat intolerance.
Though this condition is not as common as Hypothyroidism, women with hyperthyroidism still outnumber men.
Hyperthyroidism is caused by a multitude of conditions ranging from tumours in brain to generalised growth of the thyroid gland. A complete description of the causes is beyond the scope of this article, but suffices to know that the symptoms of hyperthyroidism are caused by an excess of thyroid hormone and vice versa.
The diagnosis of hyperthyroidism is also established by hormone assays of thyroid hormones.
This condition is primarily managed by medicines which block the production of thyroid hormone by the thyroid. It may also be treated by removing one half of the thyroid gland or by using a radioactive material which will kill all thyroid tissue. Use of radioactive material for ablation of thyroid generally leads to hypothyroidism over 5-10 years and hence women undergoing radioiodine ablation must be under regular follow up and early thyroxine replacement must be begun, if hypothyroidism is diagnosed in these women.
Hyperthyroidism causes plenty of problems to the pregnant women. Apart from the risk of pre term delivery and stillbirth, hyperthyroidism is associated with much complication in pregnancy. Untreated hyperthyroidism can lead to heart failure and death in pregnant women.
Apart from this problem, thyroid hormone assay is not very accurate in pregnancy because β--hcg, produced during pregnancy itself has a stimulatory action on the thyroid. So under these circumstances it become difficult to decide if the signs and symptoms of thyroid excess are due to a problem with thyroid or not.
Treatment of hyperthyroidism during pregnancy also poses problems. All drugs used in hyperthyroidism cross the placenta and can cause birth defects in your baby. However one of the drugs-propylthiouracil does not cross the placenta in sufficient quantities and is considered safe for use in pregnancy.
Thus both hyper and hypothyroidism cause many metabolic imbalances and are responsible for many deleterious effects. The aim of this article is to educate you about the various features and management of thyroid disorders. We hope that this article has cleared any doubt you have about thyroid disorders. If you have any other doubts you are free to use our Q&A tool to clarify them.