Is it really menopause?

As a woman over 40, what first comes to mind when you think of hot flashes, mood swings and decreased sex drive? "The Change", right? Not always.

It may be too much thyroid hormone. With symptoms like: intolerance to heat, night sweats, difficulty sleeping, mood swings, irritability, lighter or fewer menstrual periods, tremors, palpitations, fatigue, weight loss or gain, depression, more frequent and larger stools, it is easy to see how too much thyroid may be confused with other conditions. Hyperthyroidism, commonly called Graves disease, most often affects women between the ages of thirty and fifty at the same time the symptoms of perimenopause may begin.

I started noticing these symptoms several months ago and the last thing that I thought of was thyroid. I associated the problems with a change in hormone replacement therapy with added job stress. My husband noticed the irritability, lack of sex drive and mood swings and firmly pointed me toward the doctor for a check up.

The doctor listened to all my vague symptoms and added a thyroid screening test to the regular battery of blood tests. The levels of thyroid hormone and antibodies are easily measured in the blood. When my levels came back high, it was on to a specialist, endocrinologist, for more tests.

My results are consistent with Graves disease, an auto-immune disease first discovered by Dr. Graves in Ireland. I knew something about the disease, but associated it with the stereotype of hyperactive, nervous and skinny people not fluffy grandmotherly types.

There are other less common causes of hyperthyroidism, such as thyroiditis, an inflammation of the thyroid; nodules or lumps on the thyroid that can produce too much hormone; and ingesting too much hormone. In a stroll through the local healthfood store, I found about ten different glandular supplements containing thyroid.

Untreated hyperthyroidism may cause shortness of breath, chest pain and muscle weakness. Rarely, it may lead to heart failure, stroke or possibly, mental illness. Usually the symptoms begin gradually and increase slowly over time. People may not realize that they are sick.

Thyroiditis may resolve with symptom management. One can quit taking over the counter supplements. However, Graves disease requires intervention. The choices are simple. Take the same radioactive iodine that has been used for over forty years which will destroy some thyroid cells, probably cause the thyroid to shut down, requiring additional supplements later. Or, take the newer anti-thyroid drugs which can be liver toxic and have to be monitored very carefully. They are usually taken over at least a year and may resolve the thyroid problem. Very rarely is surgery performed, usually only if the gland is large enough to cause difficulty swallowing or breathing.

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