Why is hyperthyroidism overlooked as the source of many common symptoms?
There are three reasons that hyperthyroidism fails to be diagnosed. It is either not considered in a differential diagnosis, the sufferer experiences the symptoms of hyperthyroidism intermittently and may wait to seek treatment, or it is under-diagnosed.
One reason that hyperthyroidism is under-diagnosed can be blamed on lab test interpretation. When a lab value is categorized as within a “normal” range, this means that this lab range number is derived from an average of those having blood work in the past year. This “normal” range is determined using the lab values from supposedly sick people who have had their blood drawn. Obviously, there are flaws with this system so many doctors use functional ranges when interpreting their patient’s blood work. This takes a little more effort on the doctor’s part because it isn’t as simple as just looking at whether the results are in the normal column or not. Finding a doctor who is cognizant of these functional lab ranges is vital for proper management of thyroid disorders.
Another reason hyperthyroidism is overlooked is that the sufferer may exhibit symptoms similar to other disease processes. For example, a person who complains of persistent diarrhea may be diagnosed with irritable bowel syndrome. Another patient may express a depressive disorder and be under care with psychotropic medication. Sometimes, once a label has been given to a set of symptoms the investigation into other causative factors will end. It is then up to the sufferer to continue looking for other diagnostic and treatment options.
There are also many cases where the symptoms of hyperthyroidism will come and go. The person may disregard these symptoms until their condition deteriorates.
Hashimoto’s thyroiditis is a condition that exhibits fluctuating thyroid symptoms with bouts of both hyperthyroidism and hypothyroidism. Hashimoto’s was discovered over a century ago but still remains relatively unknown to the American public. It is an autoimmune condition and is characterized by the immune system attacking and slowly destroying the thyroid gland. During an immune system attack, the damaged thyroid gland releases too much thyroid hormone into the body causing metabolism to rev up. This results in the common symptoms of hyperthyroidism i.e. a fast heart rate, weight loss, etc. When the attack eases, there is less of the thyroid gland left to make hormones so metabolism drops. This causes decreased metabolism. Lab tests will only show what is happening in the body at the time the blood is drawn. Lab values in a patient with Hashimoto’s will fluctuate depending on what is happening at that time with the immune system’s attack on the thyroid gland. This can make it difficult for an inexperienced medical practitioner to diagnose Hashimoto’s based on routine bloodwork alone. Specific lab testing can confirm a diagnosis of Hashimoto’s thyroiditis.
