Women Suffer from Thyroid Disease More Than Men

By Jennifer Wider, M.D., Society for Women's Health Research

Diagnosis of thyroid diseases has become increasingly common, especially among women. More than 27 million Americans have thyroid conditions, which result when too little or too much thyroid hormone circulates in their bodies. More than half of the cases go undiagnosed and, what's more, roughly eight out of 10 people with thyroid disease are women.

"Although we are not certain why many thyroid conditions are five to 10 times more common in women than in men, we do know that this is not likely to be a hormonal effect of estrogen since these conditions can occur before puberty and long after menopause," explains Rhoda H. Cobin, M.D., clinical professor of medicine at The Mount Sinai School of Medicine in New York City and president-elect of the American College of Endocrinology.

There may be a genetic link to these disorders. Researchers at Mount Sinai are currently investigating the genetics of autoimmune thyroid disease. "It is likely that the gender predisposition is likewise genetically mediated," says Cobin. In other words, women may inherit a predisposition to these disorders based on their gender.

Most people don't pay much attention to their thyroid, a butterfly-shaped gland in their neck. But when a person experiences a problem with his or her thyroid, it's virtually impossible to ignore. This little gland plays an important role in the regulation of many of the body's organs including the heart, liver, brain, kidneys and skin.

If left untreated, thyroid disease can wreak havoc on the body and leave a person at risk for heart disease, infertility and osteoporosis. According to the American Association of Clinical Endocrinologists, there is a possible genetic tie between thyroid disorders and other autoimmune conditions including diabetes, lupus and certain forms of arthritis.

In the United States , approximately one in 50 women is diagnosed with hypothyroidism (below normal thyroid function) during pregnancy. The thyroid gland plays an important role in the immune system. But, when a woman gets pregnant, her immune system is suppressed and the function of the thyroid gland is altered. In most women, the thyroid regains normal functioning after pregnancy when the immune system is released from suppression. For some, the thyroid gland never fully recovers.

According to Cobin, in some women (approximately 10 percent of women in the U.S. ), the release from immune suppression after giving birth leads to thyroid disease following pregnancy. This "postpartum thyroiditis" results from the heightened immune response following pregnancy, which leads to the body's production of antibodies that can damage the thyroid tissue. Many women who suffer from postpartum thyroiditis have detectable levels of these antibodies in their system prior to or during pregnancy. Cobin adds, "As a result, there is a period of worsening of thyroid disease that can cause temporary hyperthyroidism (overactivity of the thyroid), followed by hypothyroidism (underactivity of the thyroid)." In some women, this condition resolves itself. In others, it can persist for a lifetime.

Women need to become aware of the signs of thyroid disease. Some common symptoms of hypothyroidism (underactive thyroid) include weight gain, fatigue, dry skin and hair, hoarse voice, constipation, heavy periods and mood swings. Pregnant women sometimes notice swelling or tenderness in the neck region. For hyperthyroidism (overactive thyroid), some of the more common symptoms include: weight loss, heat intolerance and profuse sweating, frequent bowel movements, changes in appetite, sleep disturbances and tremors.

People over age 35 and those who have any symptoms should speak with their doctors about getting tested. Considering that thyroid disease tends to run in families, people with a family history of thyroid disease should also be tested. The TSH (thyroid stimulating hormone) test is a simple blood test that checks the condition of a person's thyroid gland. If a problem exists, medication is available to keep the body's thyroid hormone levels in check.

SOURCES

New York Thyroid Center , Thyroid disease in women, Columbia University : 2003.

American Association of Clinical Endocrinologists, Take Control of Your Health: Keep your thyroid in balance. 2004.

Jennifer Wider, M. D., is a medical advisor for the Society for Women's Health Research, a Washington, D.C.-based advocacy organization that works to improve women's health through research, education and advocacy. Wider received her medical degree in 1999 from the Mount Sinai School of Medicine in New York City . During medical school, she interned for the ABC news program 20/20 and a CBS affiliate station. Wider is frequently published in newspapers, magazines and web sites and has been a guest on CBS HealthWatch, National Public Radio and various cable channels. Wider is a past managing editor of the health channel at iVillage.com. For the Society, she writes a biweekly news service article and is author of a booklet for consumers called "Just the Facts: What Women Need to Know About Sex Differences in Health."