The thyroid gland sits in the front of your neck, just below and to either side of your Adam's apple. In size and shape, the gland resembles a butterfly. Its rather diminutive size--it weighs less than an ounce--belies its importance. The hormone produced by your thyroid travels through your bloodstream to receptor sites on each and every cell in your body. Once it "docks," the hormone sets the rate of cellular metabolism. In other words, it tells the cell how fast to work.

 

The amount of thyroid hormone that is available in your bloodstream determines each cell's metabolic rate. If the hormone is in short supply, cells behave sluggishly. Their impaired performance can translate into any of a number of health problems, depending on the types of cells involved. If a thyroid hormone deficiency affects nerve cells, for example, thinking may slow down, or depression may set in. If it affects muscle cells, strength declines. If it affects intestinal cells, the digestion of food and absorption of nutrients may be compromised. If it affects skin cells, acne, eczema, hair loss, and other dermatologic disorders may occur.

The immune system is especially vulnerable to low levels of thyroid hormone. White blood cell production slows down, and lymphocytes lose the aggressiveness with which they usually attack and remove infectious and allergenic invaders. Because thyroid hormone regulates metabolic activity within the endocrine system, a hormone deficiency obstructs the functioning of the system's glands and organs. (The thyroid itself is part of the endocrine system.) These components, which also include the thymus gland, adrenal glands, pancreas, ovaries, and testicles, may be unable to maintain their own hormone outputs at optimum levels. This decline in hormone production can lead to an array of physical symptoms: fatigue (adrenal glands), digestive dysfunction (pancreas), infertility and menstrual irregularities in women (ovaries), and infertility in men (testes).

Hypothyroidism is a great masquerader, with vague symptoms that can mimic those of scores of other ailments. Many people who have the condition don't even realize it. In fact, the American Association of Clinical Endocrinologists estimates that only half of those afflicted have actually been diagnosed. No wonder hypothyroidism was dubbed the unsuspected illness by pioneering endocrinologist Broda Barnes, M.D., Ph.D. Dr. Barnes's pioneering work has brought greater understanding of the thyroid gland's pivotal role in human health.

 

The symptoms of hypothyroidism usually arise from the sluggish behavior of another organ or system within the body. Without thyroid hormone to give it marching orders, the organ or system simply doesn't know quite what to do. Nothing is whipping it into action. As a result, the organ or system just languishes, a victim of hormone deficiency.

The single most common complaint among people with under-active thyroids is low energy. But since the condition can cause any organ or system to function below par, symptoms can include heart palpitations, high cholesterol, digestive problems, constipation, circulatory problems, anemia, allergies, frequent infections, sleep disturbances, fatigue, muscle weakness, hair loss, dry skin, acne, eczema, infertility, premenstrual syndrome, memory loss, depression, difficulty losing weight, and intolerance of extreme heat or cold. All of these are physical manifestations of the metabolic slowdown that accompanies thyroid hormone deficiency. You can see why doctors so often fail to suspect hypothyroidism. They're dealing with a condition that takes many forms.

An under-active thyroid can contribute to more serious health problems as well, including heart disease, immune disorders, nervous system disorders, and the like. In such cases, treating the presenting symptoms--the obvious, outward signs of illness--won't be effective unless the underlying thyroid imbalance is corrected as well.

Hypothyroidism can manifest itself as any of the following conditions. If even one of them applies to you, then you may have an under-active thyroid.

Most people go to their doctors with some idea of what's wrong with them--"My neck hurts," "This wart won't go away," "My allergies are acting up." But I've yet to have a patient say to me, "Dr. Smith, my thyroid gland is bothering me." It's always something else. One of my patients, Ellen, said that she felt cold all the time. Herb had high blood pressure. Mary complained of constant fatigue. Joe's eczema drove him crazy. Sue couldn't lose weight. Al suffered from chronic headaches. Elizabeth struggled with severe premenstrual syndrome. Mel lost all interest in sex. Jenny couldn't get pregnant (and no, she isn't married to Mel). Jeff couldn't shake his allergies. Carol was plagued by recurrent infections. Michael didn't have any symptoms at all--just elevated cholesterol. When tested, every one of these people had an under-active thyroid.

I've found that certain symptoms serve as fairly accurate predictors of hypothyroidism. I usually test for the condition whenever a patient has one or more of the following: high cholesterol, anemia, allergies, fatigue, infertility, premenstrual syndrome, chronic infection or illness, or temperature intolerance.

Age plays a part in hypothyroidism. While anyone can develop the condition, it is especially common in people over 50. In fact, it is the most often overlooked diagnosis in this age group. As you get older, thyroid function declines. The gland's once-abundant hormone output dwindles to a mere trickle. (This phenomenon affects all of the glands and organs that produce anti-aging hormones, not just the thyroid.) The resulting hormone deficiency can speed up aging. And--here's the real kicker--it can produce physical and mental changes that mimic the aging process itself.

Just think of the sorts of ailments normally associated with growing old: fatigue, circulatory problems (feeling cold), dry skin, depression, digestive problems, memory loss, muscle weakness. Every one of these can result from a thyroid hormone deficiency. The distinction may not seem important until you consider this: When a person over 50 experiences some type of physical or mental decline, both doctor and patient may write it off as "normal aging." They may not even discuss treatment. Yet thyroid hormone replacement could make all the difference in the world.

This brings to mind a patient of mine by the name of Sam Goodwin. A retired business executive in his seventies, Sam had been healthy all of his life. But then he started to experience a puzzling array of symptoms. He felt cold and tired most of the time. He had trouble remembering things. He no longer cared about sex. His entire body seemed to be shutting down. He mentioned all of this to his doctor, who simply replied, "You're getting up there, Sam. What do you expect?"

Needless to say, the doctor's remark didn't sit well with Sam. That's when he came to see me. All of his laboratory tests checked out fine. But his basal metabolic temperature was running about ½šF low, a good indicator of hypothyroidism. I started Sam on a trial dose of thyroid hormone. Within a few weeks, he reported noticeable improvements in his stamina, his memory, and his libido. I continued to monitor Sam's treatment for a few months, adjusting the hormone dose a couple of times. Within six months, his initial symptoms had all but disappeared.

Clearly, Sam's problems had nothing to do with "normal aging." They were the handiwork of an under-active thyroid gland. And Sam is not alone: Millions of folks suffer from hypothyroidism. Unfortunately, the majority of them have not been tested or treated for the condition.

If you have any of the conditions listed in "Signs of Trouble",  you may very well have an under-active thyroid gland. In that case, check your basal metabolic temperature (BMT), using the guidelines presented in "Testing Yourself for Hypothyroidism." If your temperature is consistently below 97.8šF, you probably have an under-active thyroid. Report your findings to your doctor, along with any other symptoms you've been experiencing.

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