For the Media Prevalence and Prevention of Thyroid Disease in the USA
Editor’s note: Dr. Cooper clearly demonstrates that the prevalence of thyroid dysfunction both as unrecognized thyroid illness and improperly treated thyroid conditions are far greater than previously suspected. 4.1 million men and 8 million women have either hyper- or hypothyroidism that is unrecognized and untreated.
Of even greater concern is the fact that only 60% percent of individuals taking thyroid hormone have thyroid levels, including TSH levels, in the normal range. This may reflect patients who are purposely being given high levels to suppress the growth of cancer, nodules, or goiters. Those who are hypothyroid are at risk of increases in blood cholesterol and other lipids, fatigue, depression, constipation, and changes in skin and hair. Health risks are even greater for those taking too much thyroid hormone. As Dr. Cooper points out 28% of those over sixty will develop the very dangerous cardiac arrhythmia known as atrial fibrillation over the next ten years and risk heart attack and stroke.
The Thyroid Foundation of America would like to work with members of the media, government agencies, and other groups to increase public awareness of these unrecognized and high-risk problems.
Lawrence C. Wood, MD, FACP
Preventive medicine focuses on avoiding or lessening the impact of disease in a susceptible population. There are three distinct types of prevention:
Primary prevention is the prevention of new disease in previously healthy individuals. This typically includes public health measures, such as eating a healthy diet, getting vaccinations, and wearing seat belts. In the realm of thyroid disease, ensuring an adequate iodine intake is the major way to prevent thyroid disease in iodine-deficient areas of the world.
Secondary prevention is the prevention of progression of mild or latent disease to more severe disease. A prime example of secondary prevention would be the use of mammography screening to detect the earliest stages of breast cancer. In the case of thyroid disease, secondary prevention involves screening of individuals for mild or "subclinical" hypothyroidism; if mild hypothyroidism is detected, secondary prevention would also entail treatment with thyroxine to prevent progression to a more advanced degree of thyroid failure.
Tertiary prevention is the term used to describe the prevention of worsening of already present disease. This involves monitoring for disease progression with clinical and laboratory assessment, and, theoretically, avoiding iatrogenic disease (inadvertent illness induced by the doctor), such as thyroid hormone overdose.