Thyroid Hormones
Thyroid disorders are 5-10 times more common in women
than in men. The reason for this has not been understood until recently when
it was shown that the immune problems that can cause infertility, implantation
failures, in vitro fertilization (IVF) failures and infertility could also damage
the thyroid gland. In fact many fertile women who deliver a live born infant
subsequently develop thyroid disorders and suffer secondary infertility. Doctors
have long accepted the fact that thyroid disorders as well as other autoimmune
conditions are far more common in women than in men but have had very little
science to underpin the reasons for this. Autoimmune thyroid disease is a term
that encompasses Graves' disease, Graves' orbitopathy, Hashimoto's thyroiditis
and post partum thyroiditis.
Thyroid abnormalities can be detected by doing a thyroid panel consisting of
TSH Thyroid Stimulating Hormone 0.4-5.5
T-3 Uptake Short Acting Thyroid Hormone 22-35
T-4 (Thyroxine) Total Long Acting Thyroid Hormone 4.5 - 12.5
Free T 4 Index (T-7) 1.4 - 3.8
When the thyroid is overactive, called Hyperthyroidism, the
TSH may be high or low, and the T-3 and T 4 are high. When the thyroid is
underactive (Hypothyroidism), the TSH is high and the T-3 and the T-4 are low.
The conditions are often referred to as Graves' Disease (Hyperthyroidism or
overactive thyroid) and Hashimoto's Thyroiditis (Hypothyroidism or underactive
thyroid).
The treatment for the Hyperthyroidism consists of drugs to suppress the overactive
condition. These are Propylthiouracil( PTU), and in some women Radioactive Iodide
which causes thyroid ablation. Sometimes the PTU drug is be taken prior to and
during pregnancy. Occasionally this condition has its onset during pregnancy or
in the immediate post partum period. Some women develop nodules or goiters and
need to have surgery to correct this.
The treatment for Hypothyroidism consists of thyroid hormone replacement. These
drugs are usually very much like T-3 and or T-4 or both. They are taken daily to
prevent the symptoms and body changes associated with this condition.
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