Signs of aging may be treatable hypothyroidism

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As cosmetics become increasingly scientific and effective, we can choose from a growing range of skin lotions, hair care preparations and other health and beauty products that may diminish many signs of aging.

But for millions, dry and wrinkling skin, brittle hair, fatigue and anemia — as well as a host of other complaints ordinarily attributed to “getting old” — result from a form of thyroid disease, not ordinary aging.

“Ordinary aging affects the outer layers of the skin, principally the epidermis,” explains E. Chester Ridgway, M.D., head of the division of endocrinology at the University of Colorado Health Sciences Center in Denver. “Many new skin preparations at least briefly suppress epidermal effects of aging.”

But many of the cosmetic signs of premature aging are also the signs of hypothyroidism (low thyroid hormone levels), Ridgway points out.

For those patients, Ridgway explained, doctors can order a new blood test that detects hypothyroidism declared “normal” by old tests … and signs and symptoms of the disease can be reversed with an inexpensive daily prescription tablet.

Low thyroid hormone

“Hypothyroidism” results from low levels of thyroid hormone that is produced by the thyroid gland, which straddles the windpipe.

Just as an individual with diabetes might take synthetic insulin to replace the hormone normally secreted by the pancreas, an individual with hypothyroidism takes synthetic thyroxine. In time, when properly dosed, thyroxine reverses most or all of the cosmetic as well as physiologic effects of thyroxine deficiency — particularly in those individuals diagnosed early in the course of the disease.

Disease undiagnosed

Thyroid disease is a common medical condition, affecting approximately seven to eight million Americans — mostly women. Of those, six to seven million suffer from hypothyroidism, the failure of the thyroid gland to produce sufficient hormone for the proper functioning of cells. Another one million Americans suffer from hyperthyroidism, a condition in which the thyroid produces excess hormone.

Until recently, early hypothyroidism was difficult to confirm with laboratory blood tests. Doctors might have suspected hypothyroidism, but traditional thyroid tests came back “normal” or “low normal.”

Today, hypothyroidism can be diagnosed with a blood test that is almost 100 percent accurate. Those individuals diagnosed as hypothyroid can be treated with levothyroxine at an average cost that is usually less than $10 a month.

Despite the ease with which hypothyroidism can be diagnosed, and the low cost of treatment, as many as half of hypothyroid Americans have not been diagnosed.

Mistaken for aging

How could so many people be walking around with undiagnosed hypothyroidism? Part of the explanation lies in the apparently benign nature of the disease, and part, in the way the disease often “fools” conventional blood tests.

In a society focused on fatal disorders like heart diease, cancer and AIDS, hypothyroidism appears quite benign. Although rarely life-threatening, hypothyroidism does more than make middle-aged women — and men — look older than their years. It affects every cell in the body, and can result in disorders of the heart, liver and reproductive organs.

When a patient comes to a doctor with a pain in a specific site, potential diseases or injuries immediately come to mind. The relatively vague symptoms of thyroid disease can appear unrelated and may suggest psychosmotic — not physical — illness.

Result: Even in patients with symptoms of hypothyroidism, the diagnosis of hypothyroidism may be overlooked. Changes in appearance that often provide clues to hypothyroidism are often overlooked or dismissed as normal or premature aging, especially in middle-aged women approaching menopause.

Routine tests fail

Even when doctors might suspect hypothyroidism, the best-known blood tests often fail to detect it. The conventional blood tests look at the levels of thyroid hormone in the bloodstream. Levels within a certain range are termed “normal.”

When these conventional tests are done on a woman in whom the doctor suspects hypothyroidism, they may appear to be normal. At that point, cosmetics and counseling — not pharmaceuticals — may appear the only alternative. However, under hormonal influence of another endocrine gland, the pituitary, the thyroid can appear to produce normal thyroxine levels, even when it is failing.

Within the past five years, family doctors have begun looking for hypothyroidism using a more sensitive test well established among endocrinologists. Called the “TSH assay,” this blood test detects the slightly increased levels of thyroid stimulating hormone (TSH) produced by the pituitary gland when the thyroid begins to fail.

Thanks to more precise testing, and levothyroxine doses that precisely match the thyroid hormone levels each patient needs, sufferers from hypothyroidism have new freedom from this disorder’s unwanted physical and emotional effects.

Warning signs

Hypothyroidism affects between six and seven million Americans, about half of whom are undiagnosed. Here are some of the most common signs and symptoms:

Loss of hair, especially at end of eyebrows

Dry, scaly skin; brittle nails

Intolerance to cold temperatures

Anemia

Elevated cholesterol

Abnormal menstrual periods (heavy or scant)

Muscle weakness, stiffness, cramps

Constipation

Aches, pains, arthritis

Hoarse voice

Weight gain despite a diminished appetite

Lack of energy, fatigue, dizziness, swollen ankles