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What’s the biggest thyroid problem women face?

The most common is hypothyroidism, when the thyroid doesn’t make enough thyroid hormone.

Without this hormone, your metabolism slows and you may gain weight, feel sluggish and tired, and get depressed.

Your periods may become irregular and you may have dry skin and nails.

About 10% of all women have an underactive thyroid; the condition affects about only 3% of men.

What increases the risk of thyroid disease?
The types and frequency of thyroid disease vary around the world, based on the amount of iodine in the diet.

Smoking also increases risk.

Don’t we get enough iodine in our diets from iodized salt?
Overall, Americans have been getting enough iodine since salt iodization was started in the 1920s.

But the amount in the American diet has decreased by about half since the 1970s.

That’s partially due to a decline in the amount of [iodized] salt we eat.

But there’s also less iodine in certain foods than before, particularly cow’s milk and bread.

That’s because iodate dough conditioners are used less often by many bread manufacturers.

Also, federal legislation in the 1980s limited the amount of iodine in cattle feed, which may be one reason why milk has less iodine.

In fact, 30% of the salt we purchase for household use in this country isn’t iodized.

Most sea salt, for example, doesn’t contain iodine.

In addition, most of the salt we eat is in commercially processed foods and many commercial food processors use non-iodized salt.

Why is iodine deficiency a concern?
Iodine deficiency is a huge problem in some countries, especially for pregnant and breastfeeding women.

Because iodine is needed to make thyroid hormone, which is needed for brain development, iodine deficiency can cause brain damage in unborn babies.

In the U.S., the American Thyroid Association has recommended that all pregnant or breastfeeding women take a prenatal vitamin that contains 150 mcg of iodine daily.

Why do some women have thyroid problems after pregnancy too?
As many as 1 in 10 women develop postpartum thyroiditis – inflammation of the thyroid within several months after giving birth.

When the thyroid gets inflamed, it can leak out hormone, so you become a little hyperthyroid [when the gland overproduces thyroid hormone].

Then, when you run out of thyroid hormone, you may become hypothyroid until your gland heals.

Symptoms can be very subtle. Some women lose weight; others feel anxious.

You might blame these things on being a new mom. But if the diagnosis is missed, it’s not usually critical. If it’s really mild, you just watch it. The whole thing resolves within several months in most women.

If it’s severe, you may need treatment for the symptoms.

In most women, the hyperthyroid and hypothyroid phases last several weeks.

But not all women experience both phases. About 5% of women will be left with permanent hypothyroidism.

It tends to recur in subsequent pregnancies and it’s also more common in women with autoimmune diseases.

So should all pregnant women get a thyroid test?
The concern is that low thyroid hormone in pregnant women may be associated with lower IQ in their children.

Universal thyroid screening in expectant women has been controversial.

The American Association of Clinical Endocrinologists suggests that all pregnant women should be tested.

The American Congress of Obstetricians and Gynecologists says that asymptomatic women should not be tested. The Endocrine Society recommends testing if a woman has symptoms of hypothyroidism or if she has anti-thyroid antibodies, a family history of autoimmune disease or other risk factors for hypothyroidis

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