by Dr. Steven Garner, M.D.

Dear Dr. Garner,

I am 35 years old and in good physical condition. Lately, I notice that my hair has become thin and is falling out. My menstrual cycle has also become irregular.

My mother tells me that something similar happened to her, and they found that her thyroid was not working properly. What do you think?

Thyroid Concerns in

College Point

Dear Thyroid Concerns,

Thyroid disease is one of the most under-diagnosed diseases. Millions of Americans have the disease and don’t even know it. The disease is often confused with infertility, heart problems and depression. Women are affected significantly more often than men. It is especially important for a female to fully understand the effects of the disease and how it can be treated.

The thyroid is a small butterfly-shaped gland found on either side of the Adam’s apple. It is the main thermostat of the body, controlling energy and metabolism. It can be overactive or underactive.

You may be at high risk for thyroid disease if you are female, a smoker, have a family member with the disease, have been treated with lithium, have just had a baby, have been exposed to large amounts of radiation, have fibromyalgia, have chronic fatigue syndrome or have been treated with X-rays for acne.

The diagnosis is made by a combination of a physical exam and blood tests. The actual level of thyroid hormone and other related hormones can be determined. The doctor will evaluate the gland for any nodules or lumps. A sonogram may be ordered to examine the gland for any masses or enlargement.

The good news is that thyroid disease can be treated. Whether due to an overactive or underactive gland, with the use of medication or surgery, a person with thyroid disease can live a normal life.

Thyroid disease falls into the category of autoimmune disease. This means that the body attacks itself, in this case the thyroid gland. The gland loses its ability to function properly, and either a state of too much or too little thyroid hormone occurs. No one knows why this autoimmune reaction occurs. It is similar to what happens in diabetes, except in that disease, it is the pancreas that is attacked by the body.

Autoimmune disease is much more prevalent in women.

Occasionally, a cancer will develop in the thyroid gland. It may not produce any symptoms other than a lump in the gland. It is important that a yearly physical be performed. Your doctor may order a small needle biopsy, in which the nodule is punctured by a small needle, and cells are sent to the pathologist for review.

If the disease is discovered early, a full recovery is likely.

It is important to have a normally functioning thyroid gland. If it starts to fail, many other body organs will eventually develop damage or even die.

I suggest that you make an appointment with your physician and get this checked.

Dear Dr. Garner,

I am a healthy 65-year-old man or at least I thought so. About the only health issue anyone could accuse me of was being a little underweight.

While crossing 86th St. last week, I felt a twinge of pain in my back. It persisted for three days before I visited my doctor. He took an X-ray and said I had fractured my backbone, and that my bones looked weak on the X-ray. He has scheduled me for an additional X-ray, but he said he thinks I have osteoporosis. Isn’t that a woman’s disease.  What is going on here?

Bones Brittle and Breaking in Bensonhurst

Dear Breaking in Bensonhurst,

It is true that more cases of osteoporosis occur in women than in men. However, it is a misconception that men will never experience this disease. In fact, more than two million men in the United States have osteoporosis, and most don’t know it. After age 50, six percent of all men will experience hip fractures and five percent will have a fracture of their backbone, due to osteoporosis.

I hope that your question will serve as a wake-up call for men, so they might realize they are not immune from this terrible disease.
It is known as a “silent disease” because it progresses without symptoms until a fracture occurs. Men tend to experience the disease later in life than women, because they have larger skeletons to begin with and their bone loss starts later because they don’t have the drastic hormone drop at menopause that women do.

The cause of osteoporosis is related to the fact that bone is constantly changing. Old bone is removed and replaced by new bone. Until people reach the age of 30, more bone is made than is lost.

Men in their 50s do not experience the rapid loss of bone mass that women do in their years following menopause. By the age of 65, however, men and women lose bone mass at the same rate.

Very little new bone is made, and as a result, the bones become fragile and are likely to fracture. The most common areas to fracture are the hip, spine and wrist. Twenty percent of patients will die within a year of experiencing a hip fracture.

Fortunately, there are new medications available to treat osteoporosis.  Some are taken by mouth.

Unfortunately, those taking pills often complain of severe heartburn and other side effects and stop taking the medication. There are also injectable medications which serve as an alternative to pills.

There are some conditions/circumstances which predispose a person to develop osteoporosis, such as:
• Steroid medications for conditions such as arthritis or asthma
• Low testosterone levels
• Excess alcohol consumption
• Heavy smokers
• Chronic lung disease and asthma
• Anti-seizure medications
• Immobilization
• Certain cancers
• Thyroid disease
• Arthritis

Some people may not have any of the above, but simply experience weak bones from normal aging

The good news is that osteoporosis can be effectively treated if it is detected before significant bone loss has occurred. Your doctor will do a complete medical history, X-rays and urine and blood tests. He has probably ordered a bone density test (DEXA Scan), which is a simple way in just minutes to determine how strong one’s bones are.

While women receive this test at the time of menopause, doctors often neglect to order it for men. As a result, the diagnosis is not often made until there is a fracture or back pain.

It is very important for men to inform their doctors of any risk factors they might have. A simple way to check for undiscovered osteoporosis is to measure one’s height every six months. Any loss should alert the patient and doctor to immediately evaluate for osteoporosis.