Women and Thyroid Disease

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.

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

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

Risk factors include:

• 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 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 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.⁶ 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.¹³

• 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 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.

Siemens Healthcare Diagnostics offers a complete solution for fully diagnosing and monitoring thyroid disease:

• Comprehensive thyroid menu on the IMMULITE^® and ADVIA Centaur^® platforms. Major thyroid hormone assays are available on the Dimension Vista^® and Dimension^® Integrated Chemistry systems.
• From initial screening and diagnosis through ultrasound-guided biopsy procedures, Siemens ACUSON^® Systems offers a series of affordable, high-resolution ultrasound products for the evaluation and management of thyroid disease.