“It’s an obstacle course, my whole life. Magali is 41 and has been hypothyroid for 20 years. I found out about my disease completely by accident, during a visit to occupational medicine where the practitioner noticed a goiter* and recommended a thyroid check,” That’s what my career transitions consultant said I didn’t even know what it was! Located at the base of the neck, the thyroid gland is a butterfly-shaped hormonal gland about 4 to 5 centimeters across.
It produces thyroid hormones called T3 and T4. “T4 in the blood turns into T3, this is the hormone that activates the body: it can be compared to a key,” explains Dr. Jan Goodbert, a thyroid oncologist at Purdue. So the thyroid gland acts on the whole body: the heart, the digestive system, sex, thermogenesis … “Thyroid hormones are vital. Without them, the body gradually falls asleep, and there is a danger of death ”, continues the oncologist.
However, sometimes, the thyroid gland doesn’t work: this is called thyroid dysfunction. These disorders are numerous and take many different forms, but they can be categorized into two main types of diseases. In the first case, the volume of hormones produced is too high, then we are talking about hyperthyroidism. its symptoms? “It’s like you’re having a lot of coffee all the time, picture by Jan Godbert. You have hot flashes, severe nervousness, tremors, palpitations and diarrhea as well as feeling irritable and losing weight. To treat it, there are various solutions, such as injections of radioactive iodine that attacks the thyroid gland to neutralize it, or in More serious cases, partial or total removal of the hormonal gland.
In a second, more common case, the production of thyroid hormones is insufficient: we are talking about hypothyroidism. This produces the opposite symptoms of hyperthyroidism: “You feel like the day after the party, the doctor says. You don’t want to do anything, you feel tired but can’t recover, you find it hard to focus, you feel very cold and you gain weight. Also, transit slows down. On the treatment side, lifelong replacement hormones are prescribed to patients such as levothyroxine, often marketed under the name Levothyrox.
The variety of warning symptoms for these diseases makes identification particularly difficult. “Medical fugue is unfortunately almost inevitable, at the beginning of these diseases, analyzes Jan Goodbert. When someone comes to see a doctor who tells them they have a cold, depression, and weight gain, the health professional will not immediately think of the thyroid but will attribute other causes to these diseases.”
An experience of Celine, 40, who remembers the beginning of her illness: “At about twenty, I felt unwell, my head was often confused, and this put me in great difficulty during my studies.” Doctors do not take the young woman seriously, until her symptoms worsen: fatigue Chronic, severe hair loss, joint pain … During her first pregnancy, the ax falls: Celine suffers from severe hypothyroidism. She was immediately put on treatment, adjusting her dose of Levothyrox over the years.
“Today, the thyroid gland is very sensitive and goes out of order very quickly,” says the patient’s light voice. Every two months it changes. What is very difficult for me is not returning to a “normal” life and suffering from such extreme fatigue that sleep cannot cure.”
The hormonal events involved?
According to the French Association of Thyroid Diseases (AFMT), nearly three million people were treated with hormone replacement in 2020, and therefore hypothyroidism. It is difficult to estimate how many people have been treated for hyperthyroidism because there is no conventional treatment such as Levothyrox. However, it will be lower than in patients with hypothyroidism, according to several doctors.
If, as the HAS notes in a note, it is difficult to estimate the incidence of thyroid disorders in the general population, several studies have already shown that women are most affected by these diseases. Thus, according to data collected between 1994 and 2002 by HAS, 7 men out of 10,000 developed dysthyroidism, compared to 40.3 women out of 10,000, nearly six times more than the women involved.
But why this overrepresentation? “We don’t have a clear explanation yet about this, sorry Dr. Philippe Supina, general practitioner and scientific advisor at AFMT. We have to admit that we don’t know. Françoise Burson Chazout, endocrinologist at Lyon University Hospital and thyroid reference at the French Society of Endocrinology Deaf, “Phenomena associated with hormonal events in a woman’s life. »
In fact, the health care professional notes that “the frequency of thyroid problems is the same in boys and girls until puberty, when the ratio changes. Thyroid disorders are then over-represented in women and increase in frequency after the age of 40.”
Françoise Burson-Chazzot notes that cases of thyroid disorders are over-represented in women, especially in those “over 40”. However, AFMT President Chantale L’Hoir noted “a renewal of issues over the past years”. Rather, the activist calls for “spontaneous screening for hyperthyroidism during major life periods such as puberty, pregnancy, menopause…”.
For Philip Supina, the explanation for the increase in cases among younger people is quite different: “There is no rejuvenation of patients: we simply screen for thyroid disorders too often, which mechanically leads to increased numbers.” The “excessive” test according to Françoise Bourson-Chazzot: “TSH, which is secreted by the pituitary gland responsible for stimulating the production of thyroid hormones, is one of the most frequently performed tests in the analysis laboratories in the city, above the analyzes of diabetes control,” the professional reports.
The Lyon-based endocrinologist added: “Today we are seeing an excess of thyroid hormone therapy that is useless for patients with the risk of causing excessive doses that can be dangerous to the heart. Françoise Bourson Chazotte also reminds us of the need to take at least two blood samples before starting treatment.
“In the imagination of some patients, the thyroid gland takes on great importance and they can maintain an almost emotional connection with their treatment,” the doctor was surprised. Jan Goodbert, concerned that patients think the thyroid gland is in control of everything perfectly: “Not all isolated symptoms are thyroid-specific, but a cluster of symptoms that persists over time can indicate a problem. However, some patients attribute all their problems to thyroid, while sometimes you have to research more. Someone who is depressed before they get sick will always be on levothyroxine once…”
* An increase in the size of the thyroid gland, marked by severe swelling in the neck.
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