1. Who should go for a thyroid screening and how regularly? Also, who is most at risk for thyroid issues? (i.e. age, range, sex, family history, etc.)

Thyroid screening is offered as a part of most health checks. There is no age barrier to disease affecting this gland, however being a woman and increasing age can increase one’s chances of developing the disease. The following groups should be considered for screening:

  • Those with a personal or family history of immune system diseases carry a risk of developing thyroid problems. Autoimmune thyroid disease such as Hashimoto’s thyroiditis involves the production of antibodies against one’s own thyroid gland. Other illnesses with a similar cause such as Type 1 diabetes (early onset usually), coeliac disease, diabetes and rheumatoid arthritis can co-exist in sufferers or their family members.
  • Pregnancy outcome has now been linked to thyroid function so an early check in pregnancy is advisable. Some women may develop an inflammation of the thyroid gland (thyroiditis) soon after delivery.
  • Certain other medications used in mental health disease and heart disease can affect the thyroid.
  • Children demonstrating poor growth must be checked for an under functioning thyroid. Babies are screened routinely at birth in most neonatal units now.
  • Some nonspecific complaints would alert the doctor to investigate further (see below).

The need for regular checks arises in some high risk groups such as those with autoimmune problems or those where the likely cause cannot be removed such as ongoing medication.

2. What are some thyroid-related problems or symptoms that may alert a patient that they might benefit from a thyroid screening?

Thyroid related complaints may be subtle and come on gradually and can be easily overlooked. Fatigue, unexplained weight gain, lethargy, mental slowing, depression, dry hair/ hair loss, dry skin, puffiness around the face, constipation or feeling very cold should all alert us to check this very important gland. Similarly a sudden onset of fast heartbeat, anxiety, tremor or weight loss would make us check for an over functioning gland. Swelling of the neck (goitre) with difficulty swallowing or obvious lumps on the neck may be other complaints.

Many of us who have grown up in iodine deficient areas and this is an extremely important nutrient to make enough thyroid hormone and can contribute to an under functioning thyroid.

If one has diabetes or an autoimmune condition mentioned above, it is worth a check of your thyroid.

3. How is the test done? Is there pain involved?

This is a simple blood test and there is minimal pain involved. In some cases an ultrasound scan of the neck (a non-invasive test) may be advised. If there is a clear lump, you may need to see a specialist to investigate it further (this is not very common).

4. What kind of information will the results of my thyroid screening test give my doctor?

As some of the complaints described above can be due to many other reasons, the tests can check if the thyroid gland is the bad guy. It can show raised antibody levels to the thyroid. Interpretation can be difficult in some cases if some values are borderline and the doctor may decide to repeat these in a few months or even trial you on medication. Other illnesses can also impact the thyroid making it sluggish and function can also slow down with age. The pituitary gland in the brain oversees the thyroid and in some cases, it may be found to be the culprit.

5. Are thyroid problems caused by my lifestyle and what can I do about it? If not, what causes thyroid issues?

Chronic stress can play a role in affecting the thyroid, as can diet and lifestyle, Stress has been known to trigger abnormal immune responses. Other causes could include certain viral infections, medications taken for other reasons, nutritional deficiencies such as iodine and selenium. People who may have had radiation therapy can also be predisposed.

6. What treatments are available to fix thyroid problems and how quickly will I see results?

If the results clearly show the need to treat, supplementing with thyroid hormone should start to show benefits within a few weeks. The dose may need altering based on a test done six to eight weeks later. Correcting stress, lifestyle, nutrition as well as testing and treating for nutrient deficiencies would be a holistic approach to the condition. Often a dramatic response with greater energy, quicker thinking, weight loss and improvement of mood is seen with appropriate treatment.

An over functioning gland would require specific medication. As a GP, we often seek advice from an endocrinology specialist when achieving ideal thyroid function proves to be a problem or if there are thyroid lumps.

Dr Charu
Complete Healthcare International Pte Ltd

Our Services