M Health Fairview expert clears up thyroid confusion
The thyroid is a gland surrounded by large amounts of misinformation that can make getting the right care and treatment difficult. That misinformation might lead people to believe they have a thyroid disorder.
Lynn Burmeister, MD, an endocrinologist with M Health Fairview and a professor with the University of Minnesota Medical School, helps separate thyroid fact from fiction.
Fact: The thyroid can affect body weight.
The thyroid is a butterfly-shaped gland in the neck. It produces hormones that help regulate your metabolism, heart rate, and body temperature. It gets a lot of attention because it can affect energy metabolism, sometimes impacting weight.
Thyroid disorders are also very common. About 20 million people in the United States have one of the two main types of thyroid disorder:
Hyperthyroidism is an overactive thyroid, meaning it produces too much of the thyroid hormones the body needs. Signs may include racing heartbeat, fatigue, anxiety, depression and weight loss.
Hypothyroidism occurs when the thyroid doesn’t make enough of the necessary thyroid hormones. This can cause a slow heart rate, fatigue, weight gain, and depression.
The good news is that most thyroid dysfunction is easily treated. Here's what you need to know about thyroid care.
Fiction: Endocrine specialty care is needed for all thyroid conditions.
Thyroid dysfunction may be diagnosed with a simple blood test during a primary care visit. If you are found to have a thyroid disorder, especially hypothyroidism, most can be managed in primary care clinic.
Thyroid disorders have nonspecific symptoms that could indicate any number of health conditions. For example, thyroid dysfunction and sleep apnea – though two very different problems – share similar symptoms, including fatigue, low energy, sleepiness, brain fog. Your primary care provider is best positioned to look at your entire picture of health and help find the cause of symptoms.
Fact: Thyroid medication can’t help if it isn’t due to thyroid dysfunction.
“Misinformation on the internet targeting individuals with thyroid conditions or concerns leads to incorrect beliefs about thyroid diagnosis, testing, and treatment,” Burmeister said. “They lead people to believe that we’ll be able to fix multiple nonspecific symptoms, weight issues, or even to cure the underlying thyroid condition with specific diets, supplements, alternative thyroid medications, or programs. Patients are often very disappointed when I say thyroid hormone doesn't work that well for weight loss. If it did, I’d be taking it.”
Often, people want to hear that they have a thyroid diagnosis because they believe it will be an easier or less frightening fix for symptom concerns or compared with another diagnosis. However, focusing on the thyroid and not considering other causes of the symptoms could result in a missed diagnosis and inappropriate treatment.
Fiction: Natural is better.
People with hypothyroidism need replacement hormone to restore normal thyroid blood levels. The most common medication used for this is levothyroxine. Levothyroxine is a synthetic hormone that is identical to the T4 hormone made by the thyroid. It mimics the pattern of thyroid blood levels naturally produced by the thyroid most closely. Alternate thyroid treatments, such as desiccated thyroid extract, made from pig, while “natural,” do not accurately mimic human thyroid blood levels.
Because levothyroxine has a long half-life of a week, blood levels change slowly. You need to wait at least a month for it to get into equilibrium in your system, before repeating blood tests. Once your provider has found a good dose for you, yearly thyroid checks are enough.
Testing thyroid blood levels and adjusting thyroid medication doses too frequently will likely add to instability, rather than fixing them, Burmeister said.
Fact: Some supplements affect thyroid function.
Vitamin supplements are often seen as part of a healthy lifestyle, but some affect thyroid function. “Some supplements could make your thyroid function worse, and some can mislead your doctors by causing blood tests results to be inaccurate,” Burmeister said.
Biotin, which is frequently taken in high doses for skin, hair, and nail growth, can cause interference in specific thyroid blood tests – and many other tests, including some tests for heart attacks. In these cases, it can lead to inaccurate results and misdiagnosis.
Iodine is another problematic supplement. The thyroid gland uses iodine to make thyroid hormones, but high-dose iodine supplements can cause hypothyroidism or hyperthyroidism in susceptible people. Make sure your doctor knows about any supplements you’re taking.
Fact: The thyroid plays an important role in a healthy pregnancy and brain development.
Normal maternal thyroid hormone blood levels are important for the developing fetus, so people who are pregnant should take a daily prenatal vitamin containing 150 mcg of iodine. If you’re pregnant, talk to your healthcare provider about iodine. People with hypothyroid often need a higher dose of levothyroxine during pregnancy, notify your doctor if you are planning to or become pregnant.
Learn more about primary care services at M Health Fairview and schedule an appointment.
