Dear Dr. Garner,
I am 35 years old and in good physical condition. Lately, I notice that my hair has become thin and is falling out. My menstrual cycle has also become irregular. My mother tells me that something similar happened to her and they found that her thyroid was not working properly. What do you think?
Slowing Down in Sunset Park

Dear Slowing Down,

Your mother has made a logical diagnosis. I was just talking about thyroid disease with my good friends Dr. Emil Baccash and Dr. Peter Mastrorocco.

Thyroid disease is one of the most under-diagnosed diseases. Twenty-seven million Americans have the disease. About 10 million women have thyroid disease and don’t even know it. The disease is often confused with infertility, heart problems and depression. Women are affected eight times more than men. It is especially important for a female to fully understand the effects of the disease and how it can be treated. 

The thyroid is a small butterfly shaped gland found on either side of the Adam’s apple. It is the main thermostat of the body, controlling energy and metabolism. It can be over-active or under-active. If it is under-active the following symptoms may occur:

a. Infertility and recurrent pregnancy loss.
b. Worsening of menopause symptoms.
c. Low sex drive.
d. Carpal Tunnel Syndrome
e. Difficulty losing weight
f. High cholesterol levels
g. Dry, brittle hair that falls out, just like yours
h. Brittle nails
i. Depression
j. Muscle aches
k. Can’t stand the cold — need to sleep in a hot room.
If it is over-active, the following can occur.
a. Palpitations
b. Nervousness
c. Hair loss
d. Can’t stand the heat — sleep with window open
e. Hands shake
f. Emotional changes
g. Irregular periods
h. Heavy bulge
i. Swelling of lower legs
j. Oily, warm skin.

You may be at high risk for thyroid disease if:

– You have a family member with the disease
– You are female.
– You smoke.
– You have been treated with lithium.
– You have just had a baby.
– You have been exposed to radiation, examples are Russian people from Chernobyl.
– You have fibromyalgia or chronic fatigue syndrome.
– You have been treated with X-rays for acne.

The diagnosis is made by a combination of physical exam and blood tests. The actual level of thyroid hormone and other related hormones can be determined. The doctor will evaluate the gland, for any nodules or lumps. A sonogram may be ordered to examine the gland for any masses or enlargement.

The good news is that thyroid disease can be treated. Whether due to an over-active or under-active gland, with the use of medication or surgery, a person with thyroid disease can live a normal life.

Thyroid disease falls into the category of autoimmune disease. This means that the body attacks itself, in this case the thyroid gland. The gland loses its ability to function properly and either a state of too much or too little thyroid hormone occurs. No one knows why this autoimmune reaction occurs. It is similar to what happens in diabetes, only in that disease it is the pancreas that is attacked by the body. Autoimmune disease is much more prevalent in women (about 75% of the cases).

Occasionally, a cancer will develop in the thyroid gland. It may not produce any symptoms other than a lump in the gland. It is important that a yearly physical be performed. Your doctor may order a small needle biopsy, in which the nodule is punctured by a small needle and cells are sent to the pathologist for review.

If the disease is discovered early, then a full recovery is likely.

It is important to have a normal functioning thyroid gland. If it starts to fail, many other body organs will eventually develop damage or even die.

I suggest that you make an appointment with your physician. Thank you for your interesting question.

Next week we hear form an allergy sufferer, who is looking for relief. Until then, thank you and have a great week and be well.

Dr. Steven Garner is affiliated with New York Methodist Hospital in Park Slope. He is a Fidelis Care provider. he also is the host of the popular call-in cable TV show “Ask the Doctor” seen locally on The Prayer Channel.