Screening Tests for Adults (Ages 30-49)

Thyroid disease is more common than diabetes or heart disease. A problem in this hormone-producing gland can affect every system and cell in your body, leaving you vulnerable to heart disease, osteoporosis, and other illnesses. Many people have underactive or overactive thyroids but do not know it because the symptoms are vague: fatigue, mood swings, forgetfulness, weight gain, depression, even dry and coarse skin and hair. About 1 in 8 American women will develop a thyroid disorder. An underactive thyroid (hypothyroidism) is more common in women than men and often hits hardest during pregnancy, midlife, and older age.

Opinions vary on who can benefit from screening and at what age to begin.

• The U.S. Preventive Services Task Force reviewed the evidence for and against screening in 2004 and announced it could not determine the balance of benefits and harms of screening asymptomatic adults for thyroid disease.

The American Thyroid Association recommends the following:

• Everyone over 35 years of age should be screened for thyroid disorders, with women a particular concern. Get rechecked every 5 years or sooner if you have symptoms or concerns.

The American Association of Clinical Endocrinologists advises the following:

• All women should be tested for hypothyroidism by 50 years of age. Get tested sooner if you have a family history of thyroid disease.

If you have symptoms or risk factors, no matter what your age or sex, getting tested is appropriate. For other adults, the best recommendation may be to put thyroid testing (TSH, T4, T3) on your list of what to discuss with your health care provider. For example, you can ask about the value of thyroid testing if you are pregnant or planning to become pregnant. As you age and experience what seem to be natural signs of aging, particularly if you are a woman, be alert to the possibility of thyroid problems.

Sources

American College of Physicians. Inactive ACP guidelines. Available on the Internet at http://www.acponline.org/clinical_information/guidelines/past through http://www.acponline.org. Accessed 12 Feb 2008.

Georgetown University Department of Medicine. Thyroid disease: basic thyroid information. Available on the Internet through http://www.medicine.georgetown.edu. Accessed 12 Feb 2008.

National Women’s Health Resource Center. Thyroid disorders. 29 Sep 2002, reviewed 5 Mar 2007. Available on the Internet at http://www.healthywomen.org/healthtopics/thyroiddisorders through http://www.healthywomen.org. Accessed 12 Feb 2008.

American Association of Clinical Endocrinologists. Women’s endocrine health. Available on the Internet at http://www.powerofprevention.com/w_endocrine.php through http://www.powerofprevention.com. Accessed 12 Feb 2008.

American Association of Clinical Endocrinologists. 2004 thyroid awareness campaign encourages patients and physicians to take control of thyroid health (press release). 22 Jan 2004. Available on the Internet at http://www.aace.com/pub/press/release/index.php?r=20040122 through http://www.aace.com. Accessed 21 Jul 2004.

American Association of Clinical Endocrinologists. Facts about thyroid disease. PDF available for download at http://www.aace.com/public/awareness/tam/2005/pdfs/thyroid_disease_fact_sheet.pdf through http://www.aace.com. Accessed 21 Jul 2004 and 12 Feb 2008.

Goldsmith C. Hypothyroidism: easy to treat, often overlooked. 25 Feb 2002. Nurseweek News. Previously available on the Internet at http://www.nurseweek.com/ce/ce153a_print.html through http://www.nurseweek.com. Accessed 21 Jul 2004; document no longer posted.

Ladenson PW, et al, for the American Thyroid Association. American Thyroid Association guidelines for detection of thyroid dysfunction. 12 Jun 2000. Arch Intern Med 60:1573-1575. PDF available for download at http://www.thyroid.org/professionals/publications/documents/GuidelinesdetectionThyDysfunc_2000.pdf through http://www.thyroid.org. Accessed 14 Jul 2004 and 12 Feb 2008.

US Preventive Services Task Force. Screening for thyroid disease: recommendation statement. 20 Jan 2004. Ann Intern Med 140(2):125-127. Available on the Internet at http://www.guideline.gov. Accessed 19 Jul 2004 and 12 Feb 2008.

American Association of Clinical Endocrinologists. Take control of your health: keep your thyroid in balance (patient brochure). PDF previously available for download at http://www.aace.com/pub/tam2004/PatientBrochure.pdf. Accessed 21 Jul 2004; document no longer posted.

National Women’s Health Information Center, Office on Women’s Health, US Department of Health and Human Services. Thyroid disorders. Previously available on the Internet at http://www.4woman.gov/faq/thyroid_disease.htm. Accessed 15 Jul 2004; document no longer posted.

American College of Physicians. Screening for thyroid disease (position paper). 1998. Ann Intern Med 129:141-143. Available on the Internet at http://www.annals.org. Accessed 21 Jul 2004.

Helfand M and Redfern CC, for the American College of Physicians. Screening for thyroid disease: an update. 1998. Ann Intern Med 129:144-158. Available on the Internet at http://www.annals.org. Accessed 21 Jul 2004.