Ups and downs of thyroid disease

WALNUT CREEK, Calif. — Danielle Gayden of Oakland, Calif., had to stick her face in front of a fan for almost an hour to cool down. Second to her intolerance for heat was the anxiety, which caused her heart to beat 200 times a minute and sent her to the emergency room a dozen times in six months.

But Gayden, then 28 and newly married, had nothing to feel anxious about. Still, doctors prescribed anxiety medication for what she described as an overwhelming sense of terror. Had they noted her family history of thyroid disease, the ER staffers may have called an endocrinologist to check Gayden's TSH, or thyroid stimulating hormone, to see if it was too high.

The thyroid gland, located in the neck just below the larynx, is the body's metabolism master. It converts iodine into hormones that influence every cell and organ in the body, affecting our weight, mood, energy level and body temperature, says Rick Dlott, a Martinez, Calif.-based endocrinologist with Kaiser Permanente.

If hormones are too low, one is considered hypothyroid and may suffer from fatigue, high cholesterol, weight gain, dry skin and depression. Too high, or hyperthyroid, like Gayden, and one may experience anxiety, insomnia and weight loss.

It seems we only hear about the butterfly-shaped thyroid gland in conjunction with a celebrity's fluctuating weight. But the most common thyroid diseases are autoimmune, and include Hashimoto's (hypothyroid) and Graves' disease (hyperthyroid). An estimated 20 million Americans have some form of thyroid disease, and up to 60 percent don't know it, according to the American Thyroid Association.

The reasons are complex. For starters, thyroid disease is hard to diagnose because most standard blood tests don't pick up on this small but vital gland, according to world-renowned endocrinologist Kent Holtorf of Torrance, Calif. Also, symptoms are so common they are often attributed to other health problems.

Finally, even though hypothyroidism is particularly easy to catch, as it is more common in women over 6½, we interviewed dozens of women for this story who were on cholesterol-reducing medications and antidepressants long before they or their doctors realized the thyroid was to blame. Even after treatment with natural or synthetic hormones, a lot of women still suffer with symptoms because there is a discrepancy and debate among health care providers as to what is normal TSH and if it is even the most accurate marker for hypothyroidism.