HOW HEALTHY IS YOUR FAMILY THYROID?

IF your younger relatives with the inherited tendency to thyroid dysfunction have a thyroid problem,it is likely an overactive gland.Usually the symptoms may incliude complaints you have had yourself such as nervousness,palpitations,shaky hands.On the other hand older relatives especially those over the age of fifty may have hypothyroidism with symptoms such as feeling cold,tired or lack of energy which they may just accept as signs of getting old.

manifestations of thyroid dysfunction vary considerably among relatives in their character and severity. Associated symptoms signs often progress slowly. Consequently, the accuracy of clinical diagnosis is limited.Your family physician must consider and exclude thyroid dysfunction much more often than they will establish a diagnosis. If only patients presenting with clearly suggestive symptoms and signs are evaluated, many affected family relatives will remain undiagnosed. For these persons, appropriate treatment for thyroid dysfunction or conservative monitoring to anticipate its potential future consequences can only be implemented when routine laboratory screening identifies them

A number of symptoms and signs are well-established manifestations of thyroid dysfunction. Additional findings in family histories indicate increased risk of developing thyroid dysfunction. Risk factors identifiable in family history include (1) previous thyroid dysfunction patient ; (2) goiter; (3) surgery or radiotherapy affecting the thyroid gland; (4) diabetes mellitus; (5) vitiligo; (6) pernicious anemia; (7) prematurely gray hair; and (8) medications and other compounds, such as lithium carbonate and iodine-containing compounds (eg, amiodarone hydrochloride, radiocontrast agents, expectorants containing potassium iodide, and kelp).

American Thyroid Association suggest The prevalences of various forms of thyroid dysfunction are substantial thus justifying population screening.


The prevalence of thyroid dysfunction in US adults is quite high:
Hypothyroidism 2%
Mild hypothyroidism 5-17%
Hyperthyroidism 0.2%
Mild hyperthyroidism 0.1-6.0%



The serum TSH assay is an accurate, widely available, safe, and relatively inexpensive diagnostic test for all common forms of hypothyroidism and hyperthyroidism.Screening of all newborn children for hypothyroidism is already a widely accepted and legislatively mandated practice.
In addition, serum TSH measurement in adults every 5 years has been shown by decision analysis to have equivalent or more favorable cost-effectiveness in comparison with other widely accepted disease detection strategies,for example, for hypertension, breast cancer, and hypercholesterolemia. The cost-effectiveness of screening is more favorable in women and older persons. Consequently,The American Thyroid Association recommends that adults be screened for thyroid dysfunction by measurement of the serum TSH concentration, beginning at age 35 years and every 5 years thereafter. Individuals with clinical manifestations potentially attributable to thyroid dysfunction and those with risk factors for its development may require more frequent serum TSH testing

MIMICS MENTAL ILLNESS
The psychiatric disturbances which accompany hyperthyroidism and hypothyroidism, the two commonest thyroid disorders, mimic mental illness. Family members with an overactive thyroid may exhibit marked anxiety and tension, emotional lability, impatience and irritability, distractible overactivity, exaggerated sensitivity to noise, and fluctuating depression with sadness and problems with sleep and the appetite. In extreme cases, they may appear schizophrenic, losing touch with reality and becoming delirious or hallucinating. An underactive thyroid can lead to progressive loss of interest and initiative, slowing of mental processes, poor memory for recent events, fading of the personality's colour and vivacity, general intellectual deterioration, depression with a paranoid flavour, and eventually, if not checked, to dementia and permanent harmful effects on the brain. In instances of each condition, some persons have been wrongly diagnosed, hospitalized for months, and treated unsuccessfully for psychosis.
Detection of the thyroid problem is complicated by the fact that more than one memeber of your family feels anxiety and tension to some degree, that many thyroid symptoms are similar to those of other diseases, and that hypothyroidism in particular often develops insidiously over a considerable time. But the results of overlooking the thyroid can be serious. It is very important for the physician to explore fully and give the tests for thyroid dysfunction, which today are relatively simple. When effective thyroid treatment is begun, the general response is quite favorable. Vitality returns and the mental processes become efficient again

THE DANGER STRESS CAN POSE FOR YOUR FAMILY
the relationship is clear between stress and the thyroid. The number of people who cite unusually stressful experiences before the onset of hyperthyroidism seems to bear out the theory of stress as a precipitating factor. While some members of your family can come through the same upheavals without developing thyroid disease, some perhaps are predisposed to it. On the other hand, it can be argued that the illness itself, before its symptoms are manifested, is contributing to the situation of stress.

RELATIONSHIP WITH PSYCHIATRIC CASES
Your family physician must also be careful to check the thyroid in cases where psychiatric medications must be taken over a long period. Lithium, the drug commonly used to stabilize the moods and increase the efficiency of manic-depressives, can cause hypothyroidism, particularly in middle-aged women who are the most susceptible to this trouble; the hypothyroidism in its turn can produce depression, the very problem that the treatment was intended to relieve.

HOW PREGNANT FAMILY MEMBERS ARE AFFECTED
Over the past decade there has been an increasing awareness that several disturbances of thyroid function may occur in mothers after delivery which may be more prevalent than previously appreciated. Also, patients with previous thyroid problems before pregnancy may have recurrences.In Osaka, Japan, a survey of mothers 3-8 months after delivery observed on overall incidence of thyroid dysfunction at 5.5% among 507.
In Uppsala, Sweden, the prevalence of biochemical post-partum thyroid dysfunction was 6.5% in a group of 460 women, representing an overall prevalence of 4.2% among the 644 women who entered the study

THE SYMPTOMS IN A NEW MOM
studies in Toronto over the last several years have demonstrated the prevalence of thyroid dysfunction and autoimmunity in testing mothers 6-24 weeks after delivery, have found a 7.1% incidence of abnormalities.The most common symptoms of post-partum(postnatal) hyperthyroidism occurring 6-12 weeks after delivery were fatigue, increased sweating, palpitations, and perhaps nervousness and weight loss; and subsequently, common symptoms occurring 12-24 weeks post-partum(postnatal) included fatigue, weight gain, lethargy and depression in the hypothyroid phase.

To determine most accurately the correct course of post-partum(poatnatal) hyperthyroidism, a thyroidal radioactive iodine uptake test is required in the hyperthyroid phase, while ceasing breast-feeding for several days

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