A Thyroid Problem Can Mimic Almost Anything
Last week, Louis Pukelis began popping a little pill he hopes will help get his life back in order. Once a Type A guy with boundless energy, Pukelis, 36, says his health has been in shambles for the past two years. He has been plagued with skyrocketing weight, depression, fatigue sprinkled with bouts of insomnia, and high cholesterol. Now he knows what is wrong, and he's elated. "You'd think being diagnosed with a disease, you'd be bummed out, but it's the opposite. . . . It's such a relief," says Pukelis, a vice president at Ogilvy Public Relations Worldwide in Chicago. His problem turned out to be hypothyroidism--an underactive thyroid gland--treatable with a synthetic version of the hormone his thyroid isn't making.
Thyroid trouble is a master of disguise, which is why only half of the estimated 13 million Americans who have under- or overactive thyroid glands know it. "People can go years without detection because the symptoms can look like a dozen other diseases," says Pamela Allweiss, an endocrinologist at the University of Kentucky in Lexington. Recent research shows that even a subtle thyroid deficiency, if untreated for years, raises the risk of complications including heart disease. Now several medical societies are urging Congress to make a thyroid-function screen part of a routine physical for Medicare-insured seniors, and many doctors think some groups of younger people should also be tested.
Hardly subtle. The thyroid, which sits in the neck, is shaped like a butterfly, but there's nothing lightweight about its influence in the body. It secretes a hormone called thyroxine--some of which is converted into a second hormone in the liver--that regulates the workings of all the major organs. But sometimes the gland falters, pumping out too much hormone or--more often--not enough. The source of the problem can be a thyroid tumor or another gland, the pituitary, which releases a hormone of its own that stimulates the thyroid to do its job. More often, the gland may start acting up when, for unknown reasons, a person's own immune system attacks it. Thyroid troubles usually show up in middle age or later and are more common in women, often striking after pregnancy or menopause. They also seem to run in families. Before Joyce Gilbert, 58, of Reston, Va., was diagnosed with thyroid deficiency, "she would be driving but would sometimes get so tired she'd have to pull over to the side of the road to take a nap," her daughter Elizabeth Smith recalls. Last summer, Smith, 29, found that she too had thyroid problems.
Researchers have long known that a seriously malfunctioning thyroid can lead to heart disease, but recent studies raise concerns about even slight drops in thyroid function. "We see patients with high blood pressure or high cholesterol whom we place on thyroid medication and then find they can go off the heart medication," says Robert Rosenson, the director of the preventive cardiology center and lipoprotein research facility at Northwestern University Medical School in Chicago. That's one reason why doctors advocate a simple $20 to $50 blood screen for seniors.
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