Have you met your thyroid gland yet?
Your thyroid gland controls your metabolic rate–the rate at which your heart pumps, your food digests, your cells divide, and so on and so forth.
Much of the time, your thyroid’s an innocuous fellow, going about his business without drawing attention to himself. Problem is, every so often he gets his nose out of joint and instead of just announcing himself and getting the problem fixed, he mopes about, leaving his host (that’s you) mopey too (with no idea what the problem is or how to fix it.)
The Harvard Medical School Guide to Overcoming Thyroid Problems by Jeffrey R. Garber, MD, gives a psychology of this little guy–so you can understand when he might be feeling out of sorts.
I picked up this book from the library for a number of reasons:
- I have a thyroid condition
- Around half of my residents have a thyroid condition of some sort
- I’m reading every book in my library so I’d have to read it eventually
The first is a no-brainer. I’ve known I was at risk for a thyroid condition at least since my early teens. I have family history of them up the wazzoo (I’ve probably got more family with thyroid conditions than most people have family.) I’ve requested routine blood work to screen for hypothyroidism every year since I was 14 or so. Even so, my own hypothyroidism hid out as a stress-response for at least a couple of months before I got it treated. Amazingly, once I started treatment, I felt 100% better (or maybe even more.)
The second reason is interesting. Because the thyroid gland affects the body’s metabolic rate, it’s something that is always in the back of my mind when I’m assessing residents. If someone is barely eating but keeps on gaining weight, chances are I’m going to request thyroid labs. If someone is eating far more than I estimate they need and keeps losing weight, you better bet I’m going to request thyroid labs (since the alternative, cancer, is MUCH less pleasant.) I’m not always right when I guess that there might be an underlying thyroid issue–but I’ve been right often enough (and seen dramatic enough results in clinical outcomes and resident quality of life) that I’m going to keep on requesting thyroid screens when I see evidence that points that way.
But enough about my experience with thyroid issues. Let’s get to the book.
The layout of Overcoming Thyroid Problems is straightforward, first giving a simple description of the anatomy and physiology of the thyroid gland before moving through a collection of thyroid disorders from most common to least.
The reader will learn about a half dozen iterations of hypothyroidism, common and uncommon causes of hyperthyroidism, and a mess of information about thyroid lumps from benign to cancerous.
This is a pretty thorough book (excepting how it glossed over what exactly a “thyroid storm” consists of). You’ll learn about Hashimoto’s thyroiditis (most people who have it simply get the diagnosis “hypothyroid” and begin on thyroid hormone replacement therapy), Graves’ disease (did you know that both George H.W. and Barbara Bush had Graves’ disease?), multinodular goiter, and medullary thyroid cancer.
Truth be told, this book contains far more information than you or I would ever need.
Nevertheless, it’s a good book. Thyroid conditions (especially hypothyroidism) affect a huge proportion of the population–and often go undiagnosed or are misdiagnosed. This book gives individuals the tools they need to assess their risk for a thyroid condition and the information they need to be an informed thyroid patient.
Because many of you (those of you without a diagnosed thyroid condition) are not likely to pick up this book, I’ll mention a few of the common symptoms of a hypothyroidism (the most common thyroid condition) here.
If you have some or several of the following symptoms, you may benefit from having your doctor check your thyroid:
- Fatigue
- Cold sensitivity (always feeling cold)
- Loss of appetite
- Slow pulse
- Weight gain (even if you’re eating less than usual)
- Depression
- Dry skin and brittle fingernails
- Hair loss
- Constipation
- Muscular and joint pain
- High cholesterol
- Carpal tunnel syndrome
A thyroid screen involves a simple blood test that measures the amount of “thyroid stimulating hormone” (TSH) in your blood. If the TSH is high (indicating hypothyroidism), the treatment is simple: thyroid hormone replacement therapy. Pop a pill each morning, Mr. Thyroid is happy, you are happy. No fancy diets to follow, no restrictions of any sort. Take a pill, feel better.
In my experience, it’s like magic. This is one “too good to be true” that actually is true. If you’ve got hypothyroidism, treatment can change your life.
This book is a great resource for individuals who have a thyroid condition or who are at risk for a thyroid condition. If you or a close relative (since thyroid issues do have a genetic component) has hypo- or hyperthyroidism, Graves’ disease, goiter, or thyroid nodules, you might want to pick up a copy of this book. You’ll find reliable information regarding signs and symptoms of thyroid conditions, screening and diagnostic tests, and treatment options.
Rating:3 Stars
Category:Medical Reference
Synopsis:An overview of thyroid conditions, with discussion of their symptoms, diagnosis, and treatment
Recommendation: A great reference for those who have a thyroid condition, have some of the symptoms suggestive of thyroid conditions, or who have a family history that puts them at risk for a thyroid condition. (Almost) everything you’d ever need to know about thyroid conditions. (The three stars are only because of it’s narrow appeal, not because of poor information.)
I had half of my thyroid removed 22 years ago due to a benign (thankfully) nodule. I was set on a prescription of thyroid hormone which was supposed to keep my own thyroid from producing (I wondered why they left half of it if they didn’t want it to produce anything, but I forget the answer. May have had something to do with the parathyroid glands?) I was on the same dosage for years until a few years ago my doctor at that time said my numbers were running too high and lowered the dosage. My latest lab work showed it running too low, and my current doctor wants to raise it again, but not to the same level I was originally taking. I was confused about how it could fluctuate since what’s left of my thyroid is not supposed to be doing anything, and the thyroid levels I have should be coming from the pill I am taking. That’s a question for the next time I see the doctor, I guess.
Another interesting occurrence I had related to my thyroid was several years ago. It didn’t seem related at first: I was having pretty severe and frequent diarrhea, and at first the dr. just thought it was some kind of bug, but it lasted for weeks (pretty miserable to try to function like that). I was sent to a gastroenterologist, and was likely headed for a colonoscopy (I had just had one a few years earlier and was not eager to repeat the process.) In his series of questions he asked if I had had any changes in medication, and I said my thyroid medication had just been changed to a new generic. He said wrote a script for the brand name thyroid med and told me to try it — and in just a short time my problem stopped. He said that generics can vary 15% from the actual medication, meaning it can contain 85 or 115% of it, and that’s ok with most meds, but can cause problems with some like thyroid hormone. My family doctor was skeptical and surprised that changing the medicine worked, but I was never so glad to have medicine work in my life. The only downside is that Synthroid costs about $20 a month.
And now you know much more about my thyroid than you wanted to, I’m sure, and much more than any other blogger! :-)
I do not have a thyroid problem and have never understood what the thyroid does. Thanks for the little lesson!
Barbara-I’m glad you shared. I always enjoy hearing other people’s thyroid stories. They give me a chance to learn a bit more about the thyroid and sometimes give me a bit of a puzzle to “explain” using my own knowledge of the thyroid.
For example, my guess is that the reason only half of your thyroid was removed was because the risk of nicking the parathyroid gland (which is right behind the thyroid) during surgery is much higher during a complete thyroidectomy.
The reason your thyroid hormone dose had to be changed even though your thyroid theoretically shouldn’t be producing anything is because levothyroxine (the thyroid replacement hormone) is “T4” (the same hormone that is produced by the thyroid). But T4 in the blood has to be converted into the active form “T3”. If the rate at which your body converts T4 to T3 changes, you’ll need to change your dose of levothyroxine, even if your thyroid itself remains the same.
Your diarrhea story is fascinating–GI changes aren’t usually the first thing I think of when I think of thyroid dysfunction, but it makes perfect sense. The new generic must have erred on the higher end of the acceptable amount, causing you to go into a thyrotoxic (hyperthyroid) state which in turn caused increased GI motility (aka diarrhea). When you switched to the name brand, your thyroid stabilized, as did your metabolism (and your stooling patterns.)
It’s probably (okay, definitely) a bit nerdy of me, but this type of thing is a favorite part about my job. I love reading doctor’s histories and physicals, analyzing labs, looking at weight data and intake data, bowel patterns, and other symptoms and figuring out how to make all the pieces fit together so that I can provide care to residents. I love it when I get stretched to learn something new about how the body works and how each system effects the others.
So, again, thanks for sharing!