Everyone Over 35 Needs Thyroid Test, Group Says
June 16, 2000 -- The next time you go to the doctor, don't be surprised if he or she gives you a thyroid test. Even if you don't have any symptoms, you may be one of millions of Americans who have either an underactive or an overactive thyroid gland.
Many people with thyroid abnormalities have obvious symptoms that cause them to seek help, but many others do not. Because the symptoms tend to develop slowly and can mimic other things, thyroid disease is often difficult to diagnose without lab tests.
Symptoms of underactive thyroid, known as hypothyroidism, can include fatigue, weight gain, intolerance to cold, dry skin, high cholesterol, depression, and an enlarged thyroid gland. But some people have thyroid problems with no obvious symptoms at all.
An estimated 11 million Americans, many of them women over age 50, have underactive thyroid, and a smaller number -- about 2 million -- have overactive thyroid. Symptoms of overactive thyroid can include fatigue, weight loss, profuse sweating, intolerance to heat, nervousness, difficulty sleeping, and an enlarged thyroid gland.
In a recent issue of the journal Archives of Internal Medicine, a group of thyroid experts recommends that doctors start screening all adults for thyroid disease beginning at around age 35, regardless of whether they have symptoms or risk factors. They also suggest that screening be done every five years after that.
"Not everyone agrees with starting at age 35," says Gilbert H. Daniels, MD, one of the experts who helped draft the guidelines. "We think it's a reasonable thing to do." Daniels is an associate professor of medicine at Harvard Medical School in Boston.
The guidelines recommend that doctors give everyone age 35 and older a thyroid test called a serum TSH assay. If the test result is not normal, treatment varies according to the cause of the abnormal result and whether there are other related problems.
Treatment for underactive thyroid typically involves giving thyroid hormone to compensate for the lack of hormone in the body. Treatment for overactive thyroid is more complex and may involve giving a radioactive substance that slows down production of thyroid hormone. A last resort is surgical removal of the gland itself.