According to new guidelines issued by the American Thyroid Association (ATA), everyone should be screened, at a minimum, for thyroid problems beginning at age 35, at 5 year intervals. Those with symptoms, which are potentially associated with thyroid dysfunction, should be checked even more frequently.
Universal screening for thyroid problems has never been advocated before, although the American College of Physicians has been recommending thyroid screening for women aged 50 and older for the past few years.
Researchers estimate that thyroid dysfunction affects 5% to 15% of women. Although men are less affected by this problem, the ATA is suggesting screening of both sexes, since the blood test used to detect levels of thyroid stimulating hormone (TSH) costs only about $25. They state that screening is important because thyroid problems can easily go undetected and can lead to other serious conditions.
Signs of an underactive thyroid (hypothyroidism) include fatigue, weight gain, intolerance to cold, and depression. Signs of an overactive thyroid (hyperthyroidism) include fatigue, weight loss, intolerance to heat, and nervousness.
There is medication available to treat either disorder, although people with a hyperactive thyroid may require surgery.
Although thyroid screening is currently less common than screening for high blood pressure or breast cancer, the ATA maintains that it is more cost-effective than either of these screening programs. In other words, more health benefits are obtained for each dollar spent on screening and subsequent treatment.
The ATA recommends that "Americans who are concerned about fatigue and weight gain and impaired memory ought to think about the possibility of a thyroid problem,"
Archives of Internal Medicine 2000;160:1573-1575.
It is important to recognize that the traditional TSH guidelines are not sensitive enough to detect the majority of people who have thyroid impairment. I suspect that the numbers of individuals with dysfunctional thyroids are triple that quoted in the article. I have recently revised my Thyroid articles, which discuss thyroid diagnosis and treatment to make it more reader-friendly and understandable. The problem with TSH is that the reference ranges used are not quite accurate and TSH by itself is incapable of finding individuals who suffer with secondary or tertiary hypothyroidism.
It is great to see traditional medicine becoming more aggressive in trying to identify people with impaired thyroids. However, the next hurdle will be to convince them that synthetic hormones like Synthroid are a very poor choice for the vast majority of people with hormone impairment. The other central issue that is rarely addressed is that adrenal impairment will frequently cause secondary hypothyroidism.
This week I completed an interview with Mary Shomon who is the thyroid expert at www.about.com. I will post it shortly, pending her permission to publish it before it reaches her newsletter. She has one of the best books written on the subject. It was just completed a few months ago and if you have or suspect thyroid dysfunction I would strongly recommend it.