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“НАШЕ ЖИТТЯ”, ГРУДЕНЬ 2014 WWW. UNWLA.ORG 33 A COMMON MALFUNCTIONING ORGAN — THE THYROID GLAND Ihor Magun, MD, FACP The thyroid gland is a butterfly-shaped organ located in the front of the neck. It is an e n- docrine gland that secretes hormones that control our metabolism. Disorders of this gland result in either underproduction or overproduction of the- se hormones. This article will primarily focus on the thyroid’s hormonal underproduction, which is the more common disorder of the two. The incidence of too little production — hypothyroidism — increases with aging and is more often seen in women than men (ratio about 10:1). Risk factors include previous head or neck irradiation, personal or family history of some type of autoimmune disorder, previous history of postpartum thyroiditis, treatment with certain medications (lithium, amiodarone, iodides), i o- dine deficiency (rare in the U nited States), and pituitary gland issues . In some cases, the origin of the disorder is idiopathic, or unknown . Hypoth y- roidism may also be seen in certain chronic, co m- plicated medical conditions. The symptoms of hypothyroidism are va r- iable, and because the decrease in the hormone is gradual, many individuals do not feel drastic changes and feel that they are merely showing signs of aging or “that i s just the way ‘ t hey’ are.” The most common signs of the disorder include fatigue, a feeling of weakness, dry skin, hair loss, slower heart rate, weight gain, irritability, depre s- sion, irregular periods, inability to tolerate cold temperatures, infertility, reduced sweating, carpal tunnel syndrome, decreased memory or conce n- tration, muscle cramps, and paresth esia, which is a tingling, burning sensation like the one exper i- enced when one’s limb “falls asleep.” Commonly associated conditions (which can trigger an eval u- ation for hypothyroidism) are anemia, very high cholesterol levels, celiac disease, low sodium l ev- els in the blood, rapidly cycling bipolar mental disorders, and hypo parathyro idism , or an eleva t- ed concentration of the parathyroid hormone in the blood. Diagnosis for hypothyroidism is a simple blood test that shows an elevated thyroid- stimulating hormone and decreased circulating thyroid hormones due to a malfunctioning th y- roid gland. Unfortunately, there is no known cure for this condition and prescribed medications to manage thyroid hormonal levels must be a lif e- time commitment on the part of an individ u- al. The medication works best when ingested on an empty stomach, and hormone levels must be checked periodically. It takes about six to eight weeks to obtain normal thyroid hormonal levels in the blood, or what is known as “ euthyroid. ” Once a patient has become euthyroid, less blood test monitoring is required. The most common brand-name medic a- tion for the replacement of thyroid hormone is called Synthroid. It is advisable to request and obtain the branded Synthroid product instead of the generic substitutions. Insurance companies , due to cost containment, state that the generics are bioequivalent, but this statement is not always true. Different companies often provide generic thyroid hormone medications (called levothyro x- ine) that differ from each other in their bioequiv a- lent levels by as much as twelve percent. So in fact, one time you may be taking a medication that is up to twelve percent higher in potency and another time it may be up to twelve percent lower. There are individuals that do take the non-brand product and are doing well, and you should not change what works for you. I am only stating that receiving a consistent quantity of medication from one company (Synthroid) is more reliable and may require less frequent blood tests since the amount prescribed will always be the same. Discuss your individual condition with your ph y- sician who knows you well and can make the best recommendation. So the next time you go for your annual physical or if you feel you may be experiencing any of the possible symptoms outlined above, r e- quest an evaluation of your thyroid gland. If any deficiency exists, treatment is available, easy to initiate, and will provide you with the energy and relief so that you feel your “good ol’ self” again. On an ending note, I would like to extend a sincere wish of good health, happiness and good times for Christmas and the New Year. I intend to keep you informed about topics that will be informative, cutting -edge, helpful, and interesting in the coming months.
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