disease is easy to diagnose and treat, half of the cases in
America remain undiagnosed. Minor thyroid abnormalities may
go unnoticed, but data suggests that many people with low-level
thyroid problems could improve with treatment.
In an effort to
improve diagnosis of thyroid disease, the American Association
of Clinical Endocrinologists (AACE) has released new guidelines
that narrow the range for acceptable thyroid function.
base diagnosis of thyroid disease on the "normal"
range for the thyroid stimulating hormone (TSH) test. While
the previous normal range was between 0.5 and 5.0, the new
guidelines narrow the range for acceptable thyroid function
to between 0.3 and 3.04.
Under the new guidelines,
as many as 27 million people may have abnormal thyroid function--more
than double the number of people thought to have abnormal
thyroid function under the old guidelines. These estimates
would make thyroid disease more common in North America than
Women are at an
increased risk for thyroid disease, as they are five to eight
times more likely than men to be diagnosed. The elderly are
also at an increased risk--by the age of 60 years, as many
as 17 percent of women and nine percent of men have an underactive
thyroid. Thyroid disease is also linked to other autoimmune
diseases, including certain types of diabetes, arthritis and
The thyroid gland
produces hormones that influence essentially every organ,
tissue and cell in the body. Thyroid disease, if left untreated,
can lead to elevated cholesterol levels and heart disease,
infertility, muscle weakness, osteoporosis and, in extreme
cases, coma or death.
(underactive thyroid) affects some 80 percent of patients
with thyroid disease. Symptoms of hypothyroidism include fatigue,
forgetfulness, depression, constipation, and changes in weight
Experts hope that
the new guidelines will give physicians the information they
need to diagnose mild thyroid disease before it leads to serious
health consequences such as elevated cholesterol, heart disease,
osteoporosis, infertility and depression.
February 20, 2003
Association of Clinical Endocrinologist January, 2003