Hiding in Plain Sight: Diagnosing Hypothyroidism
By asking the proper questions, I diagnosed a treatable thyroid problem that my patient thought was section of aging.
by Dr. Tania Mathew
A significant part of being truly a family doctor gets to learn my patients. You start with the first visit, I wish to build ongoing, caring relationships using them as time passes. When I talk with new patients, I remember to learn about their current and past healthcare issues or concerns. Sometimes, patients don’t even recognize that they are having outward indications of a health problem. In such cases, listening carefully and asking the proper questions is particularly important. This can help me create a diagnosis or decide if the individual needs any tests.
Recently, a 40-year-old new patient named Emily (not her real name) came set for a whole physical exam. When I asked Emily if she had any health issues, she said that she was concerned about infertility. She and her husband have been attempting to conceive for greater than a year.
Initially, Emily explained she wasn’t having any health issues. But when i asked more questions about possible symptoms, I then found out that she have been having mood swings and that she felt cold more often than not. She had been gaining weight despite the fact that her diet and exercise hadn’t changed much. Emily had noticed these symptoms for quite some time but never mentioned them to a health care provider. She thought these were probably just section of getting older.
Predicated on Emily’s symptoms and her infertility concerns, I suspected that she may have hypothyroidism. Hypothyroidism (also known as underactive thyroid) is really a condition where the thyroid gland will not make enough thyroid hormones. Thyroid hormones control how the body uses energy. They affect your heartrate and how well your other organs work. In addition they affect muscle tissue, bones, and menstrual cycles (for women). Women who don’t have sufficient thyroid hormones could have a hard time conceiving a child. Find out about common outward indications of hypothyroidism, why it happens, and how it really is treated.
When I gave Emily a physical exam, I carefully felt her thyroid gland. The thyroid gland is situated in the low front of the neck and is shaped such as a butterfly. Emily’s thyroid gland felt normal. Her overall physical exam was also normal.
The U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) usually do not recommend routine screening for thyroid disorders in patients that are not pregnant and don’t have any observeable symptoms. However, due to Emily’s ongoing symptoms and her concerns about infertility, I ordered a blood test to check on her thyroid function. This test measured the quantity of thyroid hormone and thyroid-stimulating hormone (TSH) in her blood. TSH is really a hormone that tells the thyroid gland just how much thyroid hormone to create.
Emily’s blood test outcomes confirmed the diagnosis of hypothyroidism. I immediately started her on a synthetic thyroid hormone. This medicine replaces the hormones the thyroid gland is meant to create. I also ensured that Emily had regular blood tests to closely monitor her thyroid hormone levels. Treating hypothyroidism can improve a female’s likelihood of conceiving, so Emily is hoping that she’ll be capable of geting pregnant soon. Or even, I’ll refer her to an infertility specialist.
Throughout a follow-up visit, Emily explained she was surprised she had never considered to mention her symptoms during any previous doctor’s appointments. She was very grateful that I took enough time to discover more regarding her health history and concerns. With treatment, she’s noticed a standard improvement in her hypothyroidism symptoms.
Synthetic thyroid hormone is taken daily in pill form. Doctors recommend taking this medicine each day, half an hour before eating. It’s vital that you follow your physician’s instructions for how exactly to take this medicine. In the event that you don’t, your hormone levels may fall and rise. This may cause complications such as for example heart palpitations (the sensation your heart is racing), anxiety, trouble concentrating, or changes in body’s temperature. Make sure to let your loved ones doctor know when you have any unwanted effects while taking synthetic thyroid hormone.