Recognizing Thyroid Disease as Women Age

Thyroid conditions affect millions of Americans, but diagnosing them can be challenging. Up to 60% of those with thyroid disease are unaware, according to the American Thyroid Association. This puts them at risk for serious conditions, such as cardiovascular disease, infertility, and osteoporosis. Understanding how symptoms of thyroid dysfunction present differently across age groups for women is crucial to maintaining good health.

What is it?

The thyroid is a hormone-producing gland that regulates the body’s metabolism. Women are five to eight times more likely than men to have thyroid problems. It affects critical body functions, such as heart rate and energy level.

Hashimoto’s thyroid disease is the most common reason for hypothyroidism in the U.S., according to Marc Cillo, MD, an endocrinologist with UT Physicians Endocrinology – Texas Medical Center. This disease is caused by antibodies that damage your thyroid gland and cause inflammation. Over time, it prevents the thyroid gland from producing enough thyroid hormone, known as hypothyroidism.

Symptoms by age group

Identifying thyroid issues isn’t always straightforward. The presentation of conditions varies significantly with age.

Children: Children with hypothyroidism can experience weight gain, poor linear growth (height and length), and constipation. For those with hyperthyroidism (too much thyroid hormone), children might experience weight loss, agitation, insomnia, chest pains, heart rate, palpitations, and protrusion of the eyes.

Adults: Classic symptoms of hypothyroidism include fatigue, unexplained weight gain, cold intolerance, and constipation.

Perimenopause/menopause: Hot flashes can be challenging to distinguish between thyroid dysfunction and menopause, said Cillo. Other symptoms, such as fatigue, are common in both conditions.

Older adults: They may experience more serious complications, including sudden confusion, delirium, and a rare but life-threatening condition called myxedema coma.

“Thyroid-related symptoms, especially in hypothyroidism, are nonspecific and can be seen in many underlying medical issues,” said Cillo, assistant professor of endocrinology, diabetes and metabolism at McGovern Medical School at UTHealth Houston. “Regardless, thyroid blood levels should still be screened if people develop symptoms that may be explained by thyroid disease.”

Tracking thyroid through life stages

Children

Thyroid conditions may be uncommon in children, but early detection and treatment are essential for healthy development. While these disorders affect only 1%-2% of children, understanding the signs can significantly affect outcomes, according to Katherine N. Velez, MD, a pediatric endocrinologist with UT Physicians Pediatric Center – The Woodlands.

About one in 5,000 children is born with hypothyroidism, known as congenital hypothyroidism, detected with the newborn screen.

“Untreated congenital hypothyroidism leads to severe permanent cognitive delays, in addition to poor growth,” said Velez, staff physician in pediatric endocrinology at McGovern Medical School.

Pregnancy

Thyroid health is especially important for women seeking to get pregnant. Thyroid dysfunction is a known risk factor for infertility that can be potentially reversed with proper treatment, according to Cillo. He said the risks of untreated thyroid issues during pregnancy are significant.

“For hypothyroidism, risks can include miscarriage, stillbirth, preeclampsia, preterm labor, low birth weight, and postpartum hemorrhage and affect brain development for the baby in utero,” Cillo said.

Hyperthyroidism presents many of the same risks as hypothyroidism. Maternal congestive heart failure and placental abruption (the placenta separates from the womb) are additional risks that can be seen at higher rates compared to untreated hypothyroidism.

Treating thyroid conditions

Treatment options for children and adults are straightforward but essential. For those with an underactive thyroid gland, Velez said treatment involves replacing the thyroid hormone in a pill form. Treatment for an overactive thyroid gland can range from medications that block the overproduction to surgical removal.

Managing thyroid health

While genetics play a significant role, Velez said diet may also influence thyroid health. Although the relation is not entirely clear, Velez said ultra-processed meals seem to increase the risk of autoimmune thyroid diseases.

When it comes to lifestyle management, Cillo recommends a balanced approach. He said that following a healthy, well-balanced diet and maintaining regular exercise and sleep are important to support thyroid health. He advised that some foods known to affect thyroid function — soy, cruciferous vegetables (kale or broccoli), lima beans, and sweet potatoes — should be eaten in moderation.

“There is no reliable evidence that avoidance of these foods proves beneficial, but it is best to limit high intake,” Cillo said.

Cillo finds fulfillment in treating thyroid conditions. He enjoys the detailed thought process that is required in this field.

“Luckily, most of these cases have a good prognosis, and it is gratifying to provide guidance, therapy options, and reassurance for my patients,” Cillo said.