Women and Thyroid

Overview

Thyroid disease is any benign or malignant condition that affects the structure or functioning of the thyroid gland,(1) impacting its ability to produce the hormones required for proper metabolism.

Common manifestations of thyroid disease in women include hypothyroidism, hyperthyroidism, and thyroid cancer. The most common cause of thyroid disorders worldwide is iodine deficiency. In areas where iodine deficiency is not prevalent, such as in the U.S., thyroid disease in women is generally the result of autoimmune disease.(2)

Thyroid disease can affect anyone at any age, but is most prevalent among females.(3)

Globally, 1 billion people are at risk for iodine deficiency that can lead to thyroid disease.(4)

It is estimated that 200 million people in the world have some form of thyroid disease.(5)

Hypothyroidism and hyperthyroidism are 10 times more common in women than in men.(6)

Women and Thyroid Disease

Hyperthyroidism in Women

When the thyroid gland becomes overactive and produces too much thyroid hormone, a person is said to be hyperthyroid. The most common cause of hyperthyroidism in women is the autoimmune condition known as Graves’ disease, where antibodies target the gland and cause it to speed up hormone production.

Graves’ Disease

Graves’ disease is an autoimmune disorder that leads to overactivity of the thyroid gland—hyperthyroidism. Graves’ disease is the most common cause of hyperthyroidism. It is caused by an abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone. Graves’ disease is most common in women over age 20.

Graves’ Disease Risk Factors in Women(7)

Although anyone can develop Graves’ disease, a number of factors can increase the risk of disease. These risk factors include the following:

- Family history

- Gender—women are much more likely to develop Graves’ disease than are men at a ratio of 7:1

- Age—Graves’ disease usually develops in people younger than 40.

- Other autoimmune disorders

- Emotional or physical stress

- Pregnancy or recent childbirth

- Smoking

Graves’ Disease Symptoms in Women

Common signs and symptoms of Graves’ disease in women include:

- Irritability

- Difficulty sleeping

- Fatigue

- A rapid or irregular heartbeat

- A fine tremor of the hands or fingers

- An increase in perspiration or warm, moist skin

- Sensitivity to heat

- Weight loss, despite normal eating habits

- Enlargement of the thyroid gland (goiter)

- Change in menstrual cycles

- Bulging eyes (Graves’ ophthalmopathy)

- Thick, red skin, usually on the shins or tops of the feet (Graves’ dermopathy)

Hypothyroidism in Women

When the thyroid gland is underactive due to improper formation at birth, surgical removed (all or in part), or becomes incapable of producing enough thyroid hormone, a person is said to be hypothyroid. One of the most common causes of hypothyroidism in women is the autoimmune disease called Hashimoto's disease, in which antibodies gradually target the thyroid and destroy its ability to produce thyroid hormone.

Globally the prevalence of Hashimoto’s disease is 1%, but subclinical hypothyroidism affects 4% of the population. Females make up the vast majority of the patients at a ratio of 8:1, female to male.(8)

Hypothyroidism Risk Factors in Women(9)

- Family history: Having a relative with autoimmune thyroid disease

- Age: Hypothyroidism can start at any age, but the risk keeps growing as people get older.

- Gender: Hypothyroidism is more common in women than men. It is much more common in young women than young men, but as men get older, they start to catch up.

- Race: Hypothyroidism is common in Caucasians and Asians. African-Americans are at lower risk.

- Presence of other autoimmune disorders

- Down syndrome or Turner’s syndrome

The rate of hypothyroidism goes up:

- During pregnancy

- After delivery

- Around menopause

Hypothyroidism Symptoms in Women(9-10)

Hypothyroidism symptoms in women tend to develop slowly, often over several years. They may include the following:

- Dry, itchy skin

- Dry, coarse hair

- Hair loss

- Mild weight gain, and difficulty losing weight

- Slower thinking, memory loss

- Fatigue

- More frequent and severe muscle cramps and joint aches

- Puffiness around the face

- Heavier and/or more frequent menstrual periods

- Goiter (swelling in the front of the neck, caused by enlargement of the thyroid)

- Slowing of heart rate

- Slightly higher blood pressure

- Higher cholesterol levels

Thyroid Disease & pregnancy

Thyroid disease is the second most common endocrine disorder found in pregnancy. Hypothyroidism in women is associated with infertility and miscarriage. During pregnancy, complications can occur such as, preeclampsia, abruptio placenta, premature labor, and postpartum hemorrhage. The infant can also be affected with neurodevelopment problems and low birth weight.(11)

Thyroid Cancer

Thyroid cancer forms in the thyroid gland. It is the most common endocrine cancer with an increasing incidence rate globally. There are four main types of thyroid cancer, which are classified by how the cancer cells appear under a microscope: papillary, follicular, medullary, and anaplastic.(1) Most thyroid cancers grow very slowly and can either be cured or treated successfully. Only anaplastic thyroid cancer, which represents 1% of thyroid cancers, grows quickly and is difficult to control.

The worldwide incidence of thyroid cancer is increasing. This may be due to increased detection of small tumors using new, more sensitive diagnostic procedures, as well as a true increase in the overall number of cancers, a possible consequence of increased exposure to radiation or other undiscovered environmental carcinogens.(12)

Risk Factors of Thyroid Cancer in Women

Gender and age: Women are three times more likely than men to develop thyroid cancer. Women are most often diagnosed at ages 40–50, men in their 60s or 70s.

Low iodine diet: Increase in follicular thyroid cancer

Radiation: Exposure may come from certain medical treatments (e.g., neck radiation treatments in childhood) and radioactive fallout from power plant accidents and nuclear weapons.

Hereditary conditions and family history: Especially medullary thyroid cancer

Symptoms of Thyroid Cancer in Women

Symptoms of thyroid cancer in women typically do not present early and are found during a routine physical exam. The thyroid is a tiny gland (not much bigger than a quarter) and typically cannot be felt through the skin. Swelling or a lump in the neck is the most common symptom of thyroid cancer. As the tumor gets larger, other symptoms may begin to occur, such as difficulty in swallowing and hoarseness.

Solutions

DiaSino offers a complete solution for diagnosing and monitoring thyroid disease:

DiaSino ELISA and Porrima™ CLIA menu

TSH/third generation

Total T3

Total T4

Free T3

Free T4

Anti-Tg

Anti-TPO

DiaSino Infinosis™ FIA menu

TSH

FT3

FT4

http://medical-dictionary.thefreedictionary.com/Thyroid+disease
http://bmb.oxfordjournals.org/content/99/1/39.full
http://thyroid.aboutcom/od/thyroidbasicsthyroid101/a/riskfactors.htm
http:/emedicine.medscape.com article/1172273-overview#a0199
http://www.thyroid.ca/thyroid_disease.php
https://www.clinicalkey.com/topics/endocrinology/hypothyroidism.html
http://www.mayoclinic.org/diseases-conditions/Graves’-disease/basics/definition/con-20025811
Environmental Health Criteria 236: Principles and methods for assessing autoimmunity associated with exposure to chemicals. World Health Organization. 2006
http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/causes/con-20021179
http://my.clevelandclinic.org/disorders/hyperthyroidism/hic_hyperthyroidism.aspx
M. I. Nor Azlin et al “ Thyroid autoantibodies and associated complications during pregnancy”. Journal of Obstetrics and Gynaecology, October 2010; 30(7): 675–678
Pellegriti G, et al. Worldwide increasing incidence of thryoid cancer: update on epidemiology and risk factors. Journal of Cancer Epidemiology. 2013;Article ID 965212

Women and Thyroid Disease