Download an MP3 podcast about Thyroid Awareness Month, featuring patient advocate Mary Shomon


January marks Thyroid Awareness Month, and with some experts estimating that as many as 59 million Americans suffer from thyroid disease, it's never been more important for patients and doctors to understand this common -- but overlooked -- health problem.

According to patient advocate Mary Shomon, many doctors simply aren't communicating with their patients about thyroid risks, symptoms, diagnosis, and treatment. "I don't know whether the problem is lack of knowledge on the part of doctors, or cost-containment directives coming from HMOs and insurance companies. But the bottom line -- millions of people are walking around with thyroid conditions, but they are not getting properly diagnosed and treated."

To help overcome this information gap, Shomon, the New York Times best-selling author of The Thyroid Diet, as well as other popular patient-directed books, web sites, and thyroid newsletters, has put together "Thyroid 101: 10 Facts Doctors Forget To Tell You," along with a free downloadable ebook -- all designed to help educate and empower people around the world with thyroid conditions.

The free ebook, titled The Thyroid Awareness Month Guide to Thyroid Disease, is available at the campaign's website, http://www.thyroidawarenessmonth.com.

Says Shomon: "Women struggling with fertility still don't get routine thyroid tests. People who can't lose weight are still not having thyroid evaluations. Doctors frequently hand out prescriptions for antidepressants and cholesterol medications without ever testing for thyroid disease first, which is the recommended procedure. It's gotten to the point where patients truly need to be educated because they may need to take charge when it comes to their own thyroid diagnosis and treatment."

Thyroid 101: 10 Facts Doctors Forget To Tell You

Patient advocate Mary Shomon has developed the following "10 Facts Doctors Forget To Tell You" about thyroid disease.

The Almighty TSH Test: Doctors Don't Even Agree on the Results!

A majority of doctors believe that the Thyroid Stimulating Hormone (TSH) test is the "gold standard" for diagnosing thyroid disease. Unfortunately, even though they claim this test is infallible, doctors don't even agree on what the results actually mean. Some doctors follow the recommended guidelines of 0.3 to 3.0 as the TSH reference range. A group of hard-liners refuse to adopt the newer standards, however, and still follow the old reference range of 0.5 to 5.0. This means that millions of people who fall into the 3.0 to 5.0 range are in a limbo -- some doctors will diagnose and treat you as hypothyroid, others will tell you your thyroid is fine.

ACTION POINT: Says Shomon, "Being told that your TSH test results are 'normal' doesn't tell you anything. Ask for the exact number, and ask what reference range your doctor is using. And if you fall in the TSH 'limbo' of 3.0 to 5.0 and your doctor says you are 'normal,' get another opinion from a practitioner who isn't out of touch with the latest standards in thyroid care."

Your Thyroid CAN Make You Fat!

Even though doctors routinely dismiss thyroid problems as the cause of significant weight gain, studies show that patients who become hypothyroid are at substantially increased risk of obesity. Metabolism, energy, mood, blood sugar imbalances -- all are affected by an underactive thyroid, and increase the risk of weight gain.

ACTION POINT: If you are gaining weight without a change in your diet and exercise plan, or you can't lose weight despite a healthy, calorie-controlled diet and exercise, make sure you have a thorough thyroid evaluation.

Infertility Can Be a Thyroid Symptom!

Difficulty conceiving -- as well as early, recurrent miscarriages -- can be a sign of an underactive thyroid. Sadly, many physicians do not routinely perform a complete thyroid evaluation -- including TSH, Free T4, Free T3 and antibodies profile -- in women experiencing fertility problems or miscarriage. Even more shocking, many women getting expensive infertility and assisted reproduction treatments have never even had a thyroid test.

ACTION POINT: According to Mary Shomon, "Everyone experiencing infertility or recurrent miscarriage -- much less considering assisted reproduction -- should have a comprehensive thyroid evaluation."

The Thyroid Should be Evaluated Before and During Pregnancy

Women with undiagnosed thyroid conditions who become pregnant are at a higher risk of miscarriage, stillbirth, and premature birth, as well as developmental delays and mental retardation in their children. This is why it's critical for a pregnant women to be aware of her thyroid status. Most doctors do NOT do routine thyroid testing on women who are considering pregnancy, or who are newly pregnant even though even mild hypothyroidism during early pregnancy can put a baby at risk.

ACTION POINT: A women who is considering getting pregnant should request a preconception thyroid test. Newly pregnant women should have thyroid tests as early as possible during the first trimester. Says Shomon, "If you are already hypothyroid, and considering pregnancy, make sure your dosage is optimized for fertility and early pregnancy. If you are hypothyroid and pregnant, confirm your pregnancy early, and see your doctor right away, because most of you will require a substantial dosage increase in early pregnancy in order to keep your baby safe and safeguard the pregnancy."

High Cholesterol Could Be Due to Your Thyroid!

In some people, high cholesterol levels, including triglycerides, are due more to the thyroid than to diet or genetics. In fact, even the prescription drug inserts from the drug companies state that thyroid disease should be ruled out before patients are prescribed cholesterol medications such as statin drugs. Unfortunately, many patients struggling to control cholesterol, or who are prescribed cholesterol-lowering medications, never receive a thyroid test. Untreated, thyroid disease can also cause resistance to cholesterol-lowering medications, making them ineffective.

ACTION POINT: Patients with high cholesterol should insist on thorough thyroid testing before the doctor prescribes medication to lower the cholesterol. Those taking cholesterol-lowering medications, like statins, and finding the drugs ineffective should insist on having a thorough thyroid evaluation.

The TSH Doesn't Diagnose All Thyroid Problems!

The Thyroid Stimulating Hormone (TSH) test measures one pituitary hormone. It does not, however, test for autoimmune diseases, and these conditions are the primary reason most people develop thyroid problems. Autoimmune diseases -- along with thyroid symptoms -- can develop long before the TSH test becomes abnormal. And some studies have even shown that treating someone who tests positive for thyroid antibodies may actually prevent development of overt hypothyroidism. That said, most physicians won't test you for antibodies, or treat those who test positive for thyroid antibodies, because they don't understand the relationship.

ACTION POINT: Says Mary Shomon, "If you have thyroid symptoms and normal TSH results, ask for autoimmune thyroid antibody testing, and treatment if you test positive." Adds Shomon, "If you have a personal or family history of any autoimmune disease, this is especially important."

If Your Sex Drive Isn't Sizzling, It Could Be Your Thyroid!

Viagra sales are still booming, and more than half of all women in the US report suffering from low sex drive at various times in their lives. Yet, even when sex drive or performance is suffering, few doctors think to check the thyroid, even though it's a common cause for sexual dysfunction.

ACTION POINT: If your libido or performance are lagging, insist on getting a thorough thyroid evaluation.

There Are Many Effective Thyroid Medications...Not Just Synthroid

Doctors rarely tell you, but there are actually multiple brands of levothyroxine, and many other options for thyroid hormone replacement. While many doctors favor the costlier market leader Synthroid, there are less expensive, equally effective brand-name levothyroxine drugs including Levoxyl and Levothroid. Beyond levothyroxine, Cytomel is a synthetic version of the active thyroid hormone, T3. Thyrolar contains a combination of synthetic hormones. And Armour Thyroid is an FDA-regulated, prescription natural thyroid drug that has been on the market for more than 100 years, and is often preferred by holistic and natural health doctors.

ACTION POINT: Says Mary Shomon: "The best thyroid drug is the one that you and your practitioner discover works best, and safely, for you." Finding that drug and dosage is a trial and error process. If one thyroid drug isn't substantially resolving symptoms, patients should talk to their doctors about trying other options. If the doctor refuses, help should be sought from a practitioner who better understands thyroid treatment options.

Some Things We're Told Are Good for Us -- Like Fluoride and Soy -- Are NOT Good for the Thyroid

More experts are beginning to understand that ingesting fluoride can have toxic effects on the thyroid. At the same time, overconsumption of soy products -- especially unfermented, isoflavone-heavy soy products like powders, pills, soy milk, and protein shakes --- can slow down the thyroid and trigger thyroid conditions.

ACTION POINT: Fluoride exposure should be limited to topical fluoride only -- avoid fluoridated water or supplements that contain fluoride. And it's wise to avoid going overboard on soy consumption, keeping soy intake to reasonable amounts of fermented soy foods like miso, tofu and tempeh.

Endocrinologists Are Not Necessarily The Best Doctors for All Thyroid Condition

Endocrinology is the specialty that looks at the endocrine system, which includes the thyroid. And it's true that if you have thyroid nodules that require evaluation or biopsy, or thyroid cancer, or Graves' disease, an endocrinologist is likely to provide the best treatment for these very specific thyroid issues. But all roads in thyroid disease tend to lead to lifelong hypothyroidism -- whether it's Hashimoto's disease, or life after RAI/surgery, most thyroid patients end up "hypothyroid -- with an underactive, nonfunctioning or nonexistent thyroid, treatment with thyroid hormone replacement.

ACTION POINT: When finding the best drug and dosage, resolving persistent symptoms, and restoring optimal wellness are the goals, an endocrinologist may not be the best choice for treatment. Says Shomon, "I tell many thyroid patients to consider a holistic MD, internist, hormone expert, or a doctor who identifies himself/herself as specializing in treating people with hypothyroidism."

Mary Shomon is the nation's leading thyroid patient advocate. She is author of 10 popular books on health, including New York Times best-selling "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "The Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "The Thyroid Guide to Hair Loss," "Living Well With Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," and "Living Well With Chronic Fatigue Syndrome and Fibromyalgia." Shomon is founder and editor of a popular thyroid website, http://www.Thyroid-Info.com, and edits an email and print newsletter and magazine for thyroid patients , "Sticking Out Our Necks: Thyroid Report." Since 1997, Shomon has also served as the Guide to Thyroid Disease at About.com, a New York Times Company. More information on Mary Shomon and thyroid disease is online at http://www.thyroid-info.com and http://www.thyroidawarenessmonth.com -- two of Shomon's advocacy sites.