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Live Chat to Professor John Lazarus about the thyroid gland. |
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The Check Up live web chat about Thyroid Conditions has now finished. Thanks to everyone who sent in questions for Barbara Myers' guest, Professor John Lazarus, President of the British Thyroid Association,
We had a great response - there just wasn't time to answer them all. Read the full transcript below.
You can also read the transcripts of previous Check Up webchats - on topics from Autism to Vaccination - by following the links on the right.
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From Lynn Shepherd:
My mother developed an under-active thyroid in her 30s (the age I am now). Can this condition be inherited, and if so, should I have myself tested?
John Lazarus:
It can indeed run in families. If you feel unwell (for example, tiredness, feeling the cold, drying of the skin) then it is reasonable to ask your GP for a test. There is currently no recommendation in the UK for routine screening in this situation, although there may be a case for screening in early pregnancy.
From Anne Longfellow:
Could my recent weight gain (10.5 stone from 8.5 stone ) be due to my underactive thyroid, HRT and/or age, or 'my own fault'?
John Lazarus:
Certainly people can put on weight with an underactive thyroid. But patients will get back to their ordinary weight with satisfactory treatment. Independent of thyroid there is a tendency for everyone, unfortunately, to put on weight as they get older. Best of luck with the diet.
From Christine Hooker:
I have very recently been diagnosed as having Hashimoto's Disease. What exactly is this and how does it differ from non-Hashimoto's hypothyroidism?
Also, does Hashimoto's predispose you to other ailments?
John Lazarus:
Hashimoto's Disease is an auto-immune inflammation of the thyroid gland in which the thyroid is slowly destroyed by thyroid antibodies. Other causes of hypothyroidism include some drugs, or following surgery to the thyroid gland. There are some other auto-immune conditions (eg pernicious anaemia, Addison's Disease and Celiac Disease) which may occur in association with Hashimoto's Disease but are less common.
From Leonie Bruce:
My daughter aged 25 is 21 weeks pregnant with second child. She had no problems with first preg. but has been diagnosed with overactive thyroid this time. She has been very ill and is now on diazapan & prosac as well as all the tyroid medication. Is this common in pregnancy and is the outcome good?
John Lazarus:
Overactive thyroid (hyperthyroidism) in pregnancy is not common (about 0.2%) and if untreated may have bad effects for the mother and baby. However, anti-thyroid drugs can be given safely during pregnancy and are effective. Your daughter can even breastfeed while on the anti-thyroid drugs. The baby should be carefully checked at birth for any transient hyperthyroidism. After delivery your daughter's thyroid functions should be carefully monitored as the over-activity could return in the post-partum period if she stops her thyroid medication.
From Joanna:
I'm pregnant and I'm so tired, more than with my first baby, I'm worried it might be my thyroid.
John Lazarus:
Certainly an underactive thryoid is not uncommon in pregancy, perhaps up to 2.5%. You should get your thyroid function checked as soon as possible and even if it is only slightly low, you should take thyroxine through the pregnancy.Thyroid hormone is very important for the development of the baby's brain and so it's critical that the right levels in the mother obtained. If your thyroid function is normal, but you have thyroid antibodies, you will be at risk of developing thyroid abnormalities after the baby is born. This is quite a common occurrence and if you're in doubt, ask your GP to check your thyroid function after the birth.
From Steve Fuller:
Can you tell me what are the 'normal' ranges for the T4, TSH tests and what sort of reading should obtained for the Thyroid antibody test. I have had a blood test and my GP says that my levels are normal, but my symptoms have continued.
John Lazarus:
The normal ranges are those supplied by the hospital laboratory and vary from lab to lab. The thyroid antibodies should be undetectable. Any level that is detectable is significant. But check with your lab. Symptoms of thyroid disease, especially underactive thyroid, are often non-specific and may be due to other causes. It may be worth checking out other causes for your symptoms.
From Matthew:
The Professor says there is no other treatment for thyroid. I read that the drug itself contains tyrosine which can be taken in its natural form. l-tyrosine an amino acid.
John Lazarus:
You are quite right that tyrosine is an amino acid and is used in the body in the production of thryoxine. However, there is no evidence that tyrosine benefit in thyroid disease. I would not recommend it.
From Jenny Blue:
Are you aware of anyone else who has found they are unable to tolerate even a very small dose of thyroxine. I cannot take any because I experience intermittent visual disturbances which mean i am unable to drive etc and also my sense of smell and taste seem to be affected.
John Lazarus:
Although very unusual, some people have an allergy to thyroxine and might be better off taking triiodothyronine (T3) in this exceptional situation. I am unable to explain your eye symptoms but if you have Graves' Disease (the usual form of over-active thyroidism), perhaps you should get your eyes checked.
From Cindy Weston:
I have an enlarged thyroid, I don't have any medication. Should I see my doctor?
John Lazarus:
If you think your thyroid is enlarged, the chances are that it's nothing serious, but you should see your doctor for a thyroid test and evaluation.
From Tracy Sharples:
I was unwell from the age of 13 yrs and had Graves disease diagnosed at 15. I am worried about the amount of radiation that may have been absorbed elsewhere in my body. I have been off contraception for 4 years with no resulting pregnancy.
John Lazarus:
If you had radio iodine for your Graves' Hyperthyroidism, there's no reason to think that the ovaries were at any risk at all to cause infertility. If, however, your thyroid function is abnormal in any way, this may reduce your chances of conceiving. So you should get your thyroid checked as soon as possible.
From RW Isle of Wight:
What is Prof Lazarus opinion re sub-clinical hypothyroidism i.e where a person's levels of T are just on the borderline? There are many anecdotal cases in the papers etc. of people being helped with e.g.depession by T supplementation even if they are borderline.
Is it true that the level at which hypothroidism is diagnosed is "political" within the NHS i.e you have to be very HT to be diagnosed as such to avoid the NHS having to pay for thyroid supplementation for the rest of your life.
John Lazarus:
Sub-clinical hypothyroidism is quite common and an important problem. In this condition the serum thyroxine (T4) level is usually towards the lower end of normal but the TSH (thyroid stimulating hormone - from the pituitary gland) is above the upper limit of normal so the thyroid is being stressed. Especially if thyroid anti-bodies are present, this condition should be treated with thyroxine. Sometimes it is reasonable to check a blood test three to six months after the initial test. You are quite right that depression can be associated with this condition and may indeed resolve when this is treated with thyroxine. It is completely untrue and false that the diagnosis of hypothyroidism or sub clinical hypothyroidism is in any way related to the cost of thyroxine therapy which itself is one of the cheapest treatments in the NHS.
From John:
I had a thyroidectomy 25 years ago, having had an overactive thyroid and now take 150 microgrammes a day to supplement. Is there any long term effects from taking supplements - I have read about the possibility of oesteoporosis.
John Lazarus:
If you are on the correct dose of thyroxine subsititution therapy, there is no danger of osteoporosis or of heart problems. If you are on too much therapy, then these risks are present. 150 microgrammes of thyroxine is a normal replacement dose and you should be reassured by this.
A message from Barbara Myers:
Thank you everyone who has emailed with their interesting questions for the professor. He has done a great job. Thanks to him. If you have any other questions you would like us to consider in the next series of Check Up, please email us at checkup@bbc.co.uk. The series will be back in November. Till then take care.
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