Experts urge testing for sluggish thyroid


An estimated 4 million people in the U.S. are walking around with un-diagnosed thyroid disease. No wonder. The most common type of thyroid disease, called hypothyroidism or "sluggish thyroid," typically doesn't cause any symptoms in its early stages. Even when symptoms do occur, they are often subtle, insidious, and easily confused with other problems. Fatigue and weight gain, for instance, might be mistaken for signs of depression. Changes in menstrual cycles and high blood cholesterol resulting from a sluggish thyroid may also mistakenly be attributed to other causes.

The good news is that hypothyroidism is easily treated with a drug that is a synthetic version of thyroid hormone, which is lacking or low in people with the condition. What's more, detecting even the mildest cases of hypothyroidism is simple with the use of a blood test. The bad news is that most physician organizations do not recommend routine screening for hypothyroidism, often claiming that the payoffs of routine administration of the blood test are not worth the additional costs it imposes on the health-care system.

Researchers at Johns Hopkins University in Baltimore argue otherwise, however. Using a sophisticated computer program to estimate the cost-effectiveness of routine screening for mild thyroid failure in adults age 35 and older, they found that the initial expense of screening would be offset by lower costs for treating thyroid-related health problems. The value of screening would be particularly pronounced among women, who are more prone than men to thyroid problems.

Consider that patients with high blood cholesterol levels resulting from hypothyroidism generally would pay less for a thyroid-replacement drug than they would for cholesterol-lowering medication. In addition, early treatment of hypothyroidism helps prevent money-draining long-term health problems.

The Johns Hopkins researchers advise adults 35 and older to have what is called a sensitive TSH (thyroid stimulating hormone) test every 5 years. Costing about $50, the simple blood test detects thyroid disease in its earliest stages. The recommendation dovetails with that of the American Association of Clinical Endocrinologists, a national medical organization whose members specialize in the treatment of thyroid disease. That group recommends that any woman over 40 be screened periodically with the sensitive TSH test.

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