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Thyroid Disease Often Missed

From: Healthscout.com

Simple blood test can detect problem, experts say

By Nancy A. Melville
HealthScout Reporter

SUNDAY, Nov. 12 (HealthScout) -- With nondescript symptoms that include lethargy, sweating and lack of sleep, thyroid disease is often missed. In fact, experts say, there are an estimated 13 million Americans walking around with undiagnosed thyroid problems.

That's why even if you don't have symptoms -- and especially if you're a middle-aged woman -- you may want to get a blood test at your next checkup.

"Detecting an overactive or underactive thyroid gland is something that is best done with what's called the TSH blood test," explains Dr. Paul Ladenson, a professor and director of the division of endocrinology and metabolism at John Hopkins School of Medicine.

"The test should be conducted not only when you have symptoms, but even as a routine screening for adults since it's such a common problem," he says.

While some say you should try to feel your own neck for thyroid lumps called nodules -- a symptom of an overactive (hyperthyroidism) or underactive (hypothyroidism) thyroid -- Ladenson advises against the idea.

"There are a lot of various normal lumps in a person's neck, and I find that even residents, medical students and people who are starting programs to learn to be endocrinologists are not very good at this skill of feeling the thyroid gland," he notes. "It's something that really needs to be learned."

"People may feel these normal lumps and start getting nervous, so I personally don't think it's a good idea for the public to be advised to feel their neck for thyroid nodules," he stresses.

In addition to lethargy and a thyroid nodule, symptoms of an thyroid problems can include sweatiness, heart palpitations, anxiety and hot flashes.

Ladenson says only about 5 percent of thyroid nodules are cancerous, but all should be removed. And if caught early, they're very treatable, he adds.

Cases of both underactive or overactive thyroid can be treated relatively easily, although most patients are placed on lifelong medication, says Dr. Daniel Kelly, director of head and neck oncology and skull base surgery at Temple University.

"Patients with underactive thyroids are placed on thyroid replacement for the rest of their lives and overactive thyroid conditions can be treated with radioactive iodine. The downside, however, is often they go from overactive to underactive, so they have to be placed on the thyroid replacement hormone anyway," he explains. "So either way, you're likely going to take a medication for an extended period of time."

Kelly says the most common side effects from thyroid replacement therapy actually result from getting too high of a dose, which produces symptoms of an overactive thyroid.