Dr Malcolm Sandler, a specialist physician and endocrinologist at Mediclinic Panorama in Cape Town, has specialized in thyroid, adrenal, metabolic and ovarian disorders and diabetes.
I recently started losing hair and gaining weight, and my energy levels have plummeted. I've been told I might have thyroid problems. What does that mean?
Thyroid disorders aren't unusual. While South African figures are unknown but US statistics suggest that about 13-million adults are diagnosed with thyroid disorders each year, and it's estimated that for every diagnosis there is someone who is undiagnosed. Women are seven times more at risk than men, and have a one-in-five chance of developing a thyroid disease.
The thyroid is a small butterfly-shaped gland in your neck that you never really think about until things go wrong. It houses the only cells capable of absorbing iodine, which it converts into hormones known as T3 and T4. Once released by the thyroid, these hormones travel through the bloodstream and help your cells convert oxygen and kilojoules into energy.
How would I know if I need a thyroid test?
A thyroid test is advisable for any woman who is unusually tired or experiencing new-onset depression. Other symptoms include:
• Brittle hair that falls out
• Dry, coarse skin
• A gravelly voice
• Puffiness in the face and around the eyes
• Aches and pains in the joints, hands and feet
• Menstrual irregularities and cramping
• increased infections, including sinus infections
• Dry, gritty eyes that develop tics and light sensitivity
• Tinnitus
• Vertigo
• Emotional symptoms, including moodiness, restlessness, sadness and other symptoms associated with depression
What can go wrong with my thyroid, and what can be done about it?
The most common problem is an underactive thyroid or hypothyroidism, which is treated with a hormone supplement to replace the missing hormone. The other common problem is an overactive thyroid or hyperthyroidism. Although surgery is sometimes used to curb this, a common and highly effective alternative is a radioactive iodine tablet that reduces the excess hormones. Two months later, a follow-up test will confirm thyroid activity and, if necessary, Eltroxin will be prescribed to get thyroid action back up to speed.
Do the two common types of thyroid disorders present with different symptoms?
Yes, the two present with symptoms that are polar opposites:
Hypothyroidism (underactive thyroid)
- Weight gain that you struggle to curb
- Severe constipation
- Feeling inappropriately cold
- Feeling sluggish
- Increased snoring, onset of sleep apnea
- Headaches
- Periods become very heavy
Hyperthyroidism (overactive thyroid)
- Weight loss in spite of increased appetite
- Diarrhoea or loose stools
- Feeling inappropriately hot
- Nervous energy and panic attacks
- Insomnia
- Muscles feel weak, especially in the arms and thighs
- Periods become very light
I need to go for a thyroid test. Should I be nervous?
Not at all, a thyroid test is easy: it's a standard blood test. At the laboratories they primarily check the level of thyroid-stimulating hormone (TSH), which indicates how efficiently your thyroid is functioning.
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This article was sponsored by Mediclinic.
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