Thyroid dysfunction
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 signs are vague: fatigue, mood swings, forgetfulness, weight gain, depression, even dry, coarse skin and hair, for example.
According to the National Women’s Health Information Center, 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.
No organization currently recommends that all adults be routinely screened for thyroid disease. Expert opinions vary on who can benefit from screening and at what age to begin.
In 2004, the U.S. Preventive Services Task Force reviewed the evidence for and against screening and announced it could not determine the balance of benefits and harms of screening asymptomatic adults for thyroid disease.
Because older adults are more often affected, the American Academy of Family Physicians recommends thyroid disease screening for men and women over 60 years of age.
Because women are affected more than men, especially older women, the American College of Physicians recommends screening women over 50 years of age, but says thyroid screening in men is not warranted.
The American Thyroid Association (ATA) and the American Association of Clinical Endocrinologists both recommend that everyone over age 35 be screened, and the ATA advises getting rechecked every 5 years.
If you have symptoms or risk factors, no matter what your age or sex, it is appropriate to get tested. A patient brochure, available at http://www.aace.com/pub/tam2004/Patient Brochure.pdf, can help you recognize the symptoms and your risk factors.
For other adults, the best recommendation may be to put thyroid testing on your list of what to discuss with your health care provider during a check-up. The two of you are in the best position to determine what would be helpful in your situation. As you age and experience what seem to be natural signs of aging, particularly if you are a woman, you will want to be alert to the possibility of thyroid problems.
Sources
American Association of Clinical Endocrinologists. Facts about thyroid disease. Available on the Internet at http://www.aace.com/pub/tam2004/fact.php. Accessed July 21, 2004.
American Association of Clinical Endocrinologists. Take control of your health: keep your thyroid in balance (patient brochure). Available on the Internet at http://www.aace.com/pub/tam2004/PatientBrochure.pdf. Accessed July 21, 2004.
American Association of Clinical Endocrinologists. 2004 thyroid awareness campaign encourages patients and physicians to take control of thyroid health (press release). 2004 Jan 22. Available on the Internet at http://www.aace.com/pub/press/release/index.php?r=20040122. Accessed July 21, 2004.
American College of Physicians. Screening for thyroid disease (position paper). Ann Intern Med. 1998;129:141-143. Available on the Internet at http://www.annals.org. Accessed July 21, 2004.
Goldsmith C. Hypothyroidism: easy to treat, often overlooked. Nurseweek News. 2002 Feb 25. Available on the Internet at http://www.nurseweek.com/ce/ce153a_print.html. Accessed July 21, 2004.
Helfand M and Redfern CC, for the American College of Physicians. Screening for thyroid disease: an update. Ann Intern Med. 1998;129:144-158. Available on the Internet at http://www.annals.org. Accessed July 21, 2004.
Ladenson PW, Singer PA, Ain K, et al, for the American Thyroid Association. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med. 2000;160:1573-1575. Available on the Internet at http://www.thyroid.org/professionals/publications/GuidelinesdetectionthyDysfunc_2000.pdf. Accessed July 14, 2004.
National Women’s Health Information Center, Office on Women’s Health, United States Department of Health and Human Services. Thyroid disorders. Available on the Internet at http://www.4woman.gov/faq/thyroid_disease.htm. Accessed July 15, 2004.
United States Preventive Services Task Force. Screening for thyroid disease: recommendation statement. Ann Intern Med. 2004 Jan 20;140(2):125-127. Available on the Internet at http://www.guidelines.gov/summary/summary.aspx?doc_id=4310&nbr=3266. Accessed July 19, 2004.
