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14 January, 2019 00:00 00 AM
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Thyroid fact sheet for women

womenshealth.gov
Thyroid fact sheet for women

Your thyroid is a small gland found at the base of your neck, just below your Adam's apple. The thyroid produces two main hormones called T3 and T4. These hormones travel in your blood to all parts of your body. The thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities together are known as your body's metabolism.

Kinds of thyroid problems can affect women

Women are more likely than men to develop thyroid disorders. Thyroid disorders that can affect women include:

Disorders that cause hyperthyroidism

Disorders that cause hypothyroidism

Thyroid nodules

Thyroiditis

Thyroid cancer

Goiter

Hyperthyroidism

Some disorders cause the thyroid to make more thyroid hormones than the body needs. This is called hyperthyroidism, or overactive thyroid. The most common cause of hyperthyroidism is Graves' disease. Graves’ disease is an autoimmune disorder, in which the body's own defense system, called the immune system, stimulates the thyroid. This causes it to make too much of the thyroid hormones.

At first, you might not notice symptoms of hyperthyroidism. They usually begin slowly. But over time, a speeded up metabolism can cause symptoms such as:

Weight loss, even if you eat the same or more food

Eating more than usual

Rapid or irregular heartbeat or pounding of your heart

Anxiety

Irritability

Trouble sleeping

Trembling in your hands and fingers

Increased sweating

Increased sensitivity to heat

Muscle weakness

More frequent bowel movements

Less frequent menstrual periods with lighter than normal menstrual flow. In addition to these symptoms, people with hyperthyroidism may have osteoporosis, or weak, brittle bones. In fact, hyperthyroidism might affect your bones before you have any of the other symptoms of the disorder.

Hypothyroidism

Hypothyroidism is when your thyroid does not make enough thyroid hormones. It is also called underactive thyroid. The most common cause of hypothyroidism in the United States is Hashimoto's disease. Hypothyroidism also can be caused by:

Treatment of hyperthyroidism

Radiation treatment of certain cancers

Thyroid removal

In rare cases, problems with the pituitary gland can cause the thyroid to be less active.

Symptoms of hypothyroidism tend to develop slowly, often over several years. At first, you may just feel tired and sluggish. Later, you may develop other symptoms of a slowed down metabolism, including:

Weight gain, even though you are not eating more food

Increased sensitivity to cold

Constipation

Muscle weakness

Joint or muscle pain

Depression

Fatigue (feeling very tired)

Pale dry skin

A puffy face

A hoarse voice

Excessive menstrual bleeding

In addition to these symptoms, people with hypothyroidism may have high blood levels of LDL cholesterol. This is the so called "bad" cholesterol, which can increase your risk for heart disease.

Thyroid nodules

A thyroid nodule is a swelling in one section of the thyroid gland. The nodule can be solid or filled with fluid or blood. You can have just one thyroid nodule or many.

Most thyroid nodules do not cause symptoms. But some thyroid nodules make too much of the thyroid hormones, causing hyperthyroidism. Sometimes, nodules get to be big enough to cause problems with swallowing or breathing. In fewer than 10 percent of cases, thyroid nodules are cancerous.

Thyroid nodules are quite common. By the time you reach the age of 50, you have a 50 percent chance of having a thyroid nodule larger than a half inch wide.

Postpartum thyroidits

Like Hashimoto's disease, postpartum thyroiditis seems to be caused by a problem with the immune system. The first phase starts 1 to 4 months after giving birth. In this phase, you may get symptoms of hyperthyroidism because the damaged thyroid is leaking thyroid hormones out into the bloodstream. The second phase starts about 4 to 8 months after delivery. In this phase, you may get symptoms of hypothyroidism because, by this time, the thyroid has lost most of its hormones. In most women who have postpartum thyroiditis, thyroid function returns to normal within 12 to 18 months after symptoms start.

Risk factors for postpartum thyroiditis include having:

An autoimmune disease, like type 1 diabetes

A personal history or family history of thyroid disorders

Having had postpartum thyroiditis after a previous pregnancy

Symptoms are the same as in postpartum thyroiditis, but they are not related to having given birth.

Symptoms are the same as in postpartum and silent thyroiditis, but the inflammation in the thyroid leads to pain in the neck, jaw, or ear. Unlike the other types of thyroiditis, subacute thyroiditis may be caused by an infection.

Thyroid cancer

Most people with thyroid cancer have a thyroid nodule that is not causing any symptoms. If you have a thyroid nodule, there is a small chance it may be thyroid cancer. To tell if the nodule is cancerous, your doctor will have to do certain tests. A few people with thyroid cancer may have symptoms. If the cancer is big enough, it may cause swelling you can see in the neck. It may also cause pain or problems swallowing. Some people get a hoarse voice.

Thyroid cancer is rare compared with other types of cancer. It is more common in people who:

Have a history of exposure of the thyroid to radiation (but not routine X-ray exposure, as in dental X-rays or mammograms)

Have a family history of thyroid cancer

Are older than 40 years of age

Goiter

A goiter is an abnormally enlarged thyroid gland. Causes of goiter include:

Iodine deficiency. Iodine is a mineral that your thyroid uses for making thyroid hormones. Not getting enough iodine in your food and water can cause your thyroid to get bigger.

Hashimoto's disease

Graves' disease

Thyroid nodules

Thyroiditis

Thyroid cancer

Usually, the only symptom of a goiter is a swelling in your neck. But a very large or advanced goiter can cause a tight feeling in your throat, coughing, or problems swallowing or breathing.

Diagnosis of thyroid disorders

Blood tests

Testing the level of thyroid stimulating hormone (TSH) in your blood can help your doctor figure out if your thyroid is overactive or underactive. TSH tells your thyroid to make thyroid hormones. Depending on the results, your doctor might order another blood test to check levels of one or both thyroid hormones in your blood. If your doctor suspects an immune system problem, your blood may also be tested for signs of this.

Radioactive iodine uptake test

For this test, you swallow a liquid or capsule containing a small dose of radioactive iodine (radioiodine). The radioiodine collects in your thyroid because your thyroid uses iodine to make thyroid hormones. Then, a probe placed over your thyroid measures the amount of radioiodine in your thyroid. A high uptake of radioiodine means that your thyroid is making too much of the thyroid hormones. A low uptake of radioiodine means that your thyroid is not making enough of the thyroid hormones.

Thyroid scan

A thyroid scan usually uses the same radioiodine dose that was given by mouth for your uptake test. You lie on a table while a special camera creates an image of your thyroid on a computer screen. This test may be helpful in showing whether a thyroid nodule is cancerous. Three types of nodules show up in this test:

Thyroid nodules that take up excess radioiodine are making too much of the thyroid hormones, causing hyperthyroidism. These nodules show up brightly on the scan and are called "hot" nodules.

Thyroid nodules that take up the same amount of radioiodine as normal thyroid cells are making a normal amount of thyroid hormones. These are called "warm" nodules.

Thyroid nodules that do not take up radioiodine are not making thyroid hormones. They appear as defects or holes in the scan and are called "cold" nodules.

Hot nodules are almost never cancerous. A small percentage of warm and cold nodules are cancerous.

Thyroid fine needle biopsy

This test is used to see if thyroid nodules have normal cells in them. Local anesthetic may be used to numb an area on your neck. Then, a very thin needle is inserted into the thyroid to withdraw some cells and fluid. The withdrawal of cells and fluid is called a biopsy. A special type of doctor called a pathologist examines the cells under a microscope to see if they are abnormal. Abnormal cells could mean thyroid cancer.

Thyroid ultrasound

The thyroid ultrasound uses sound waves to create a computer image of the thyroid. This test can help your doctor tell what type of nodule you have and how large it is. Ultrasound may also be helpful in detecting thyroid cancer, although by itself it cannot be used to diagnose thyroid cancer. You may have repeat thyroid ultrasounds to see if your nodule is growing or shrinking.

Hyperthyroidism treatment

Your doctor's choice of treatment will depend on the cause of your hyperthyroidism and how severe your symptoms are. Treatments include:

Antithyroid medicines block the thyroid's ability to make new thyroid hormones. These drugs do not cause permanent damage to the thyroid.

Radioiodine damages or destroys the thyroid cells that make thyroid hormones. For this treatment, your doctor will give you a higher dose of a different type of radioiodine than is used for the radioiodine uptake test or the thyroid scan.

Surgery to remove most of the thyroid.

Beta blockers are medicines that block the effects of thyroid hormones on the body. These medicines can be helpful in slowing your heart rate and reducing other symptoms until one of the other forms of treatment can take effect. Beta-blockers do not reduce the amount of thyroid hormones that are made.

If your thyroid is destroyed by radioiodine or removed through surgery, you must take thyroid hormone pills for the rest of your life. These pills give your body the thyroid hormones that your thyroid would normally make.

Hypothyroidism treatment

Hypothyroidism is treated with medicine to supply the body with the thyroid hormones it needs to function right. The most commonly used medicine is levothyroxine. This is a man-made form of T4.

It is exactly the same as the T4 that your thyroid makes. When you take T4, your body makes the T3 it needs from the T4 in the pills.

A man-made form of T3, called liothyronine, is also available. Some doctors and patients prefer a combination of T4 and T3 or T3 by itself. Most patients with hypothyroidism will need to be on thyroid hormone treatment for the rest of their lives.

 

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Copyright © All right reserved.

Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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