January is thyroid disease awareness month. In older people, disorders involving the thyroid gland may not always present with as many symptoms as in younger people, but incidence is higher in those over age 60. Symptoms of thyroid disease often masquerade as other disorders. In some people, for example, the only symptom of hypothyroidism might be dementia, which is often reversible with treatment.

Hypothyroidism occurs when the thyroid gland, one of the body's largest endocrine glands, produces too little thyroid hormone. Symptoms might include: memory loss, sluggishness, racing heart, feeling cold or tired, having dry skin and hair, being constipated, having muscle cramps or weight gain, or even a goiter (enlarged thyroid gland).

Hypothyroidism is often caused by an autoimmune response in which the body attacks itself, destroying the thyroid gland. In developing countries, it often results from lack of iodine in the diet (iodine occurs in egg yolks, iodized salt, and some dairy products).

People with hypothyroidism are generally treated with synthetic thyroxine (thyroid hormone) in the form of pills. Some of the trade names for this product are Synthroid, Levoxyl, Levothyroid, and Unithroid. There is also a generic form, levothyroxine. There is a great deal of controversy over whether there is a difference in the various brands and the generic version in terms of how patients respond and feel. The subject is treated with some detail in the article at this link: http://pubs.acs.org/cen/coverstory/83/8325/8325thyroxine.html

Hyperthyroidism means that the body has too much thyroid hormone. Commonly, this is caused by Graves' disease, thyroiditis (thyroid gland leaks hormone) or by nodules in the thyroid gland (solid or fluid filled lumps, most of which are non-cancerous).

Hyperthyroidism is treated in different ways. Some people will receive medications, such as Methimazole, Tapazole or propylthiouracil. These drugs control the ability of the thyroid gland to make hormone, but do not destroy the gland.

Radioactive iodine is the most common therapy, and is taken by mouth. It destroys the overactive cells in the thyroid gland, and may take several weeks to accomplish the task.

Sometimes, surgery is performed to remove a portion of the thyroid gland, but that is less commonly advised in older patients.

Thyroid cancer does occur, and the symptoms may include cough; difficulty swallowing; hoarseness; enlargement of, or lumps within, the thyroid; or swelling. According to the Mayo Clinic, "People who have had radiation therapy to the neck are at higher risk. Radiation therapy was commonly used in the 1950s to treat enlarged thymus glands, adenoids and tonsils and skin disorders. People who received radiation therapy as children are at increased risk for getting thyroid cancer."

Most people with thyroid disorders who receive good treatment live a normal lifespan.

However, although it is quite rare, there is at least one form of thyroid cancer that is very aggressive, so anyone with symptoms should not delay in having them evaluated.

For more information on thyroid disease, visit the American Thyroid Association web page at: www.thyroid.org.

Anne Springer is the public relations director of SeniorCare Inc., your local Area Agency on Aging. To reach SeniorCare, call 978-281-1750.

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