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Could menopausal symptoms be hiding a thyroid condition?

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You're a middle-aged woman. You're tired all the time and have trouble sleeping. You're gaining weight, plagued with hot flashes, and your menstrual cycle is irregular. You might assume you're going through menopause. But could it be something else?

Thyroid conditions are often misdiagnosed because they share many of the same symptoms as other medical conditions, including menopause, says Saleemah Fahmi, MD, an endocrinologist on the medical staff of Methodist Charlton Medical Center. She also says when symptoms are relatively mild and appear gradually, they are easier to overlook.

High blood pressure, a racing heartbeat, forgetfulness, depression, change in bowel habits, stiff joints, and dry skin and hair can also be symptoms of a thyroid condition.

Your Thyroid: 101

The thyroid is a butterfly-shaped gland located at the base of the neck. About 2 inches long and weighing less than an ounce, its job is to produce enough of the thyroid hormone to properly control the way your body uses energy. The thyroid also influences your body temperature, growth and development.

When too much of the thyroid hormone is produced, it causes a condition called hyperthyroidism, or overactive thyroid. Some of the major symptoms of hyperthyroidism are hot flashes, irritability and heart palpitations. Often patients lose weight without trying or gain weight due to excess hunger. When too little of the thyroid hormone is produced, it causes hypothyroidism, or underactive thyroid. Weight gain and low energy are common symptoms of hypothyroidism. It can also cause depression and low libido. Both hyperthyroidism and hypothyroidism are common conditions that can be easily managed, but at the same time dangerous if left untreated.

Other Common Thyroid Conditions

Thyroid nodules and thyroid goiters are other common conditions. Thyroid nodules are areas within the thyroid tissue that have a different texture than the normal thyroid. Thyroid nodules can be filled with fluid (cystic) or solid. Thyroid nodules may be evaluated with a biopsy or surgically removed.

Enlarged thyroid glands are called goiters. Thyroid goiters can make it difficult to breathe or swallow. Thyroid goiters can also cause voice changes or neck discomfort.

You should see a doctor if you have the symptoms of hypothyroidism or hypothyroidism mentioned above, or notice that your neck is enlarged or has a lump. See a doctor right away if you notice your eyes are bulging or inflamed, as it could be a sign of Graves disease, an autoimmune disease caused by an overactive thyroid gland. Thyroid conditions left untreated can result in serious medical conditions, including heart disease.

Who Is At Risk?

Women are 5 to 8 times more likely to have a thyroid condition than men, and the risk increases with age. One in 12 women will develop the disease within their lifetime. The biggest risk factor is having a relative with thyroid disease.

How Doctors Diagnose

Dr. Fahmi suggests women with symptoms should be screened and have a physical exam. The thyroid-stimulating hormone (TSH) blood test is the most important for diagnosing a thyroid condition, and it detects how much TSH is being produced. If the level is low, the thyroid produces too much hormone (hyperthyroidism). When the TSH level is high, the thyroid produces too little hormone (hypothyroidism).

Thyroid goiters are often discovered during a routine physical or imaging of the neck area done for other reasons. If thyroid goiters are big enough, patients may notice the enlargement themselves or symptoms due to the windpipe and esophagus being compressed.

Thyroid ultrasonography is the best way to determine if an enlarged thyroid contains thyroid nodules.


Although thyroid conditions cannot be cured, the condition can be treated to maintain normal thyroid function. Thyroid conditions are usually treated with a daily oral medication. In some cases, radiation is needed to destroy thyroid tissue or surgery to remove the thyroid.

Dr. Fahmi says once you develop thyroid disease, it's important that you continue to see your primary care physician or endocrinologist for ongoing care. Although it can be easily treated, it typically never goes away, so treatments must be monitored regularly.

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