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Doctor examining glands of female patient

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The month of January marks Thyroid Awareness Month. To help bring about that awareness, we’ve teamed up with doctors of color to keep you better informed about the conditions impacting our thyroid and overall health. 

Hypothyroidism. Hyperthyroidism. Hypo. Hyper.

When we discuss thyroid health and try to do research on what it encompasses, hypothyroidism and hyperthyroidism can sometimes be spoken of and written about interchangeably by accident (look up any “celebrities with thyroid problems” galleries online). They are two entirely different conditions with distinct symptoms and effects. To help you better understand the differences in the hopes of helping Black women get properly diagnosed if there is fear that you might be dealing with one of these conditions, we asked Dr. Kelly Wood, M.D. to explain what you need to know about both. Wood is a board-certified endocrinologist specializing in diabetes and hormones and practices in Atlanta. While she is offering her expert opinion on the topic, if you have concerns, see your physician for further insight and testing.

MadameNoire: How can people differentiate between hyper and hypothyroidism for those who get those conditions confused?

Kelly Wood, M.D.: The term hyperthyroidism refers to when the thyroid gland is overactive and there is too much thyroid hormone produced in the body. On the other hand, in hypothyroidism the thyroid gland is underactive and does not produce enough thyroid hormone. The symptoms are very different. Common symptoms of hypothyroidism include fatigue, feeling cold, weight gain, sluggishness, dry skin, hair loss and constipation. Other patients complain of memory issues or brain fogginess.

In contrast, patients with hyperthyroidism report unintentional weight loss, palpitations, feeling hot, diarrhea, tremors, insomnia, anxiety and jitteriness.

Hypothyroidism seems to be a lot more common than hyper. What is the cause, if there is one, for hypothyroidism that might explain why millions in the U.S. have it?

Yes, hypothyroidism is much more common and affects 12 percent of the population as opposed to hyperthyroidism, which only affects 1.2 percent. The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto’s thyroiditis. Our immune system makes substances called antibodies, which protect us from things that are foreign to our bodies such as bacteria and viruses. In autoimmune diseases, the immune system is tricked into making antibodies that attack our own cells. In Hashimoto’s thyroiditis, these antibodies lead to inflammation and destruction of thyroid cells leading to a loss of thyroid function. Autoimmune disorders are genetic and tend to run in families.

Other causes of an underactive thyroid include surgery and radioactive iodine used to treat Graves’ disease or thyroid nodules, some medications or a congenital hypothyroidism where a baby is born without a thyroid or only a partly-formed thyroid.

Who is most likely to get hypothyroidism?

Hypothyroidism is more common in women, especially those over the age of 60. Women are five to eight times as likely than men to have thyroid problems. Other risk factors include a family history of thyroid disease, if you have an autoimmune disease such as Celiac disease or Type 1 diabetes, as well as if you are pregnant or had a baby within the past six months.

How is it that Graves’ disease causes or is connected to hyperthyroidism?

Graves’ disease is the most common cause of an overactive thyroid (hyperthyroidism) and is responsible for about 70 percent of cases. Graves’ disease is an autoimmune illness such as Hashimoto’s thyroiditis. In Graves’ disease though, the antibodies made by the immune system bind to the thyroid cells and stimulate those cells to overproduce and release excessive amounts of thyroid hormones in the blood stream.

Like with hypothyroidism, Graves’ disease tends to run in families and is more common in women.

When is it necessary to have surgery for hyperthyroidism?

There are a few different options to treat hyperthyroidism; these include medications, radioactive iodine and surgery. Medications known as antithyroid agents such as methimazole block the thyroid gland from making thyroid hormones. In up to 30 percent of patients with Graves’ disease, these medications can cause long-lasting remission after 12 to 18 months.

Surgery where all or most of the thyroid gland is removed is a definitive method of treating hyperthyroidism. Surgery is recommended in patients who have a side effect with the antithyroid medications or in whom these drugs are ineffective. The antithyroid drugs do not lead to remission when the cause of the hyperthyroidism is an overactive thyroid nodule. These patients are usually treated with surgery or radioactive iodine for definitive management.

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