Jan 3, 2018 4 min read

Notice: Undefined offset: 0 in /usr/web/cs-washington.ogdennews.com/wp-content/themes/News_Core_2023_WashCluster/includes/single/strategically_placed_photos_article.php on line 412

Notice: Trying to get property 'term_id' of non-object in /usr/web/cs-washington.ogdennews.com/wp-content/themes/News_Core_2023_WashCluster/includes/single/strategically_placed_photos_article.php on line 412

January is Thyroid Awareness Month, so we sought out endocrinologist Dr. Wayne Evron at St. Clair Hospital to talk about thyroid issues, risk factors and treatments. Dr. Evron did his undergraduate studies and went to medical school at the University of Pennsylvania, his internship at the University of Florida and his residency at UPMC – Presbyterian Medical Center. He also did a fellowship at the University of Pittsburgh.

First and foremost, what is a thyroid and what is its purpose?

The purpose of the thyroid is to control metabolism. It is located on the neck, a small, butterfly-type organ that secretes thyroid hormone. It’s responsible for the conversion of food into energy, which is known as metabolism. Thyroid hormone is of two varieties – T4 and T3. T3 is active hormone, which allows the body to utilize calories into energy.

How common is a thyroid problem, and is age or sex a factor?

Thyroid issues affect about 20 percent of the population, with hypothyroidism, or low thyroid, being more common than hyperthyroid. It is more common as people age, although it can be found in any age group. It is much more common in woman than men – in fact, as women age and after menopause, it becomes exceedingly common.

What are some typical thyroid problems and their symptoms?

The symptoms of hypothyroidism – which can be nonspecific – are tiredness, weight gain, dry skin, irritability, depression, increase in menstrual flow, shortness of breath and extreme fatigue. As mentioned, they are very common symptomatology and often missed or treated as other factors. A goiter is an enlarged thyroid, which can be seen with both hypo- and hyperthyroidism. If the goiter gets large enough, one can experience obstructive symptoms, such as difficulty swallowing, as well as change in voice, such as hoarseness, as the vocal cord nerves run through the thyroid.

What happens if a thyroid problem goes undiagnosed or untreated?

Thyroid symptoms are often missed and can go on for some time. If the patient is hypothyroid and it’s missed, they can become severely lethargic and can even go into a coma if in fact it is missed. Elderly people in nursing homes, for instance, that have hypothyroidism, can come down with severe low temperature and go into a coma, which is a medical emergency. In terms of hyperthyroidism, one can develop atrial fibrillation, weight loss, severe weakness and even paralysis. Severe depression has actually occurred, and even psychosis can occur if it is left untreated. Congestive heart failure is also a late development of untreated thyroid disorder. Disorders that have actually been severe admissions to psychiatric facilities (have turned out to be patients) with untreated hypo- and hyperthyroidism.

Generally speaking, are most thyroid problems caused by lifestyle or are they genetic?

Most thyroid problems are not caused by lifestyle and are mostly genetic. There are some environmental aspects, such as iodine deficiency, which causes severe hypothyroidism and iodide blood. In the United States, this is very rare. There are other areas where iodine deficiency is still probable, such as in Africa or India. Other environmental factors can be medications, which can affect the thyroid both causing it to be stimulated or suppressed. These medications are some psychiatric medications, antibiotics and other common medications. There is a strong genetic component to thyroid disorders. Other things to watch out for are thyroid cancers, which present as thyroid nodules. Nodules affect about 20 percent of the population. Thyroid nodules present as bumps on the thyroid and can be found by both the patent and the doctor. They often require a biopsy to differentiate between thyroid cancer and benign etiologies.

Are there any advances in terms of thyroid treatments that you are excited about?

There are significant advances in severe metastatic thyroid cancer, which are helping people survive thyroid cancer – although most thyroid cancer is arc treated with radioactive iodine and surgery. There are many new thyroid medications that are helping people with hypothyroidism respond to low thyroid. There is a controversy in endocrinology as to whether or not we should use T3 verses T4 in treatment of hypothyroidism. Thyroid disorders are relatively easily treated if they are found. The big problem with thyroid disease is they are often under-diagnosed and people go on for some time without being discovered. n