Expert: Karen Brawner - 3/19/2004

Question
I am a 24 yr. old healthy and active female. I recently for the past month noticed that i'm extremely fatigued w/headaches and especially that my throat felt closed and sore all the time. I went to my yearly exam for "womanly things", and he noticed that i had a large mass in my throat, that my thyroid was enlarged. He immediately ordered me to get bloodwork done which will be available probably the end of next week. So, i have a bad feeling that i have hypothyroidism. My concern is the treatments and weight gain and so forth. Do you think that's what i probably have? Shall i look forward to weight gain? I am very active and work out atleast 3 times a week and my weight generally stays in the 150 lb range for my 5'9" height and i will be very upset if the effects of hormone therapy will cause weight gain. Or should i expect the opposite? DO the drugs they treat you with cause weight loss being that (assuming)i had hypothyroidism since it's swollen, you'd need an increase in thyroid hormone which would give you more hormone? Am i wrong? What do you think? What are the statistics with these treatments? Thx.

Answer
Dear Darcia,   You could have an enlarged thyroid which is commonly referred to as a "goiter".....  If it is large enough to cause your throat to close off and it is sore, it may be very possible that the thyroid will have to be surgically removed....  Once the blood work comes back it would be a GOOD idea for your doctor to order an ultrasound of your thyroid to be sure it is a goiter (enlarged thyroid) and not a tumor or nodules....  Also, often a person your age can have an enlarged goiter and NOTHING need to be done with it including no medication...  However, in your case with these types of symtoms you are having, you will either need medication for life OR surgery and medication for life.....

As for the medication causing weight gain, it will NOT do that...  Infact, you MAY loose weight or stay the same weight....  Thyroid problems like hypothyroidism can and will cause weight gain if not diagnosed early enough to keep the weight from piling on...  However, once the weight IS on, it is VERY hard to take off even with medication.....

Insteade of me trying to explain a very long and complicated medical condition, here is a web site that you MUST READ....

www.endocrineweb.com/thyroid.html

Once you have a proper diagnosis, get back to me and let me know what you find out...  Also, REMEMBER, blood work for thyroid problems can OFTEN show "within normal limits" when actually there is a thyroid problem like a goiter, tumor or nodules or cysts....  So make sure you doctor does a thyroid ultrasound and maybe even a radioactive iodine ct-scan.....

Thank you,   karen