Confusion adds to thyroid problems

Hyperthyroidism and hypothyroidism are easily diagnosed common conditions. But confusion with conditions such as chronic fatigue syndrome can cause problems. Sylvia Thompson reports

Ask anybody between the ages of say 30 and 55 and you'll find many of them will have a friend or family member who has suffered from thyroid problems.

The most common conditions are hyperthyroidism and hypothyroidism (see panel below) and, although not life-threatening, these conditions can cause a range of symptoms that are very debilitating.

The conditions are well understood medically speaking and various hormone treatments are usually successful. However, as the public learns more about symptoms of damaged thyroid gland function, there is growing confusion about whether these thyroid gland problems are linked to other more complex conditions such as chronic fatigue syndrome.

The danger lies in people self-diagnosing without adequately checking thyroid function with an endocrinologist, the medical specialist in this area.

"Hypothyroidism, which is more common, is relatively easy to manage because you are replacing the hormone, although it may take some time to get the dosage right," says Dr Séamus Shreenan, endocrinologist at James Connolly Memorial Hospital, Blanchardstown, Dublin.

Hyperthyroidism, he says, is more difficult to diagnose. "The commonest cause of hyperthyroidism in those in the 30-40 age group is an auto-immune response which blood tests can diagnose. In the 50-60 age group, the cause can be nodules in the thyroid gland that can be dissolved by radioactive iodine or can be surgically removed."

Thyroid function problems, which are more common in women, are caused by both genetic and environmental factors, according to Shreenan.

"The condition does run in families but can also be brought on by stress and viral infections," he says. However, he says that although he sees a substantial number of referrals of people with chronic fatigue syndrome, the majority of them do not have problems with their thyroid gland function.

"Some of them have borderline hypothyroidism but this may not be the cause of their chronic fatigue. One in four might benefit from treatment," he says.

Thyroid gland dysfunction can also coincide with hormonal changes in women during and before the menopause.

According to Rosari Kingston, a medical herbalist who works in a GP practice in Clonakilty, Co Cork: "Reducing oestrogen levels can lead to hypothyroidism, and a herbal tincture of wild yam can increase oestrogen levels sufficiently to solve the thyroid problem."

Kingston suggests treatment with medical herbalism should precede standard medical treatment once blood tests have confirmed the hypothyroidism diagnosis.

"Self-medication is a disaster. I like to get patients who have been diagnosed with hypothyroidism or hyperthyroidism and try them with herbs for four or five months first. If there is no improvement, then I will suggest they go on standard medication."