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Thyroid Diseases

Hypothyrodism and Female Problems?

10/28/2006

Question:

I think I shall begin in the beginning. I was diagnosed with hypothyroidism at birth. I was told that they were testing babies for it because of possible radiation (iodine?) exposure from Chernobyl (I would`ve been in the womb at the time). I don't know if that`s true since the link between Chernobyl and hypothyroidism seems to be disputable. But at any rate, I have an under active thyroid and take 150mg Eltroxin (Levothyroxine Sodium) for it a day. I`m 20 and female, weigh about 119 pounds. (btw, how much is 150 mg a day? I mean, does that mean i`m just mildly underactive or a lot or..?)

A few years ago, I started experiencing vaginal discharge. I went to my doctor but he said it was `probably normal`. I went again when I was 17 and insisted on a test. It was "inconclusive". I have no idea what they actually tested for. Someone once mentioned to me that someone they knew was on a diet for being hypothyroid, but I never thought more of it.

Could there be a link here? Should I be on a diet? Could that stop the discharge? My doctor never mentioned this at all, though he did imply the two might be linked.

Recently I got a yeast infection. I was a bit baffled as to where it came from, because I have good hygiene, had no sexual contact, not on birth control, I have a reasonably good diet, I don`t wear tight nylon, or any of the other causes that I found listed. Until I found `under active thyroid` listed somewhere by chance, and again it said some vague stuff about diet. It happens that I also feel very tired all day, a bit depressed, feel cold all the time, etc, seemed like typical hypothyroid symptoms. I suppose work stress and a little cold I recently had could`ve caused the infection. I have the strong gut feeling that even if this goes away, it`ll come back because the underlying cause hasn`t been tackled.

Maybe my eltroxin dose isn`t high enough? I know it went up a few times when I was growing up, but in the past year or so i`ve been feeling pretty drained. I just kept putting it down to simple laziness, plus I had to take iron tablets for anemia.

Am I on to something, or am I being a complete hypochondriac?

Answer:

If your doctor has done thyroid blood tests on you and they are normal, then none of your problems can be attributed to your thyroid condition. Your body doesn't care whether your thyroid hormone is coming from your thyroid gland or a pill, as long as it is getting the right amount. If your thyroid level hasn't been tested within the last year then you should see your doctor for testing.

Even if your thyroid level is abnormal, I don't think your yeast infection and discharge have anything to do with your thyroid. Recurrent yeast infections can sometimes occur in diabetics. If you haven't been tested for diabetes, that would be a reasonable step to take.

Diet therapy is really not a part of the treatment of an underactive thyroid. You don't need to alter your diet as long as you are taking the proper dose of thyroid hormone.

Your dose of thyroid hormone is higher than I would have predicted from your weight, but many times patients born without a thyroid do require higher-than-usual doses. If the thyroid blood test is normal, then this is the right dose for you. I can't really tell from your dose how underactive your thyroid gland might be. If it is only slightly underactive it still would be common practice to give you a full replacement dose of thyroid hormone. If the thyroid were only slightly underactive, it would simply slow down and allow the thyroid hormone from the pill to replace all of the body's needs.

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Response by:

Thomas A Murphy, MD, FACP, FACE Thomas A Murphy, MD, FACP, FACE
Associate Professor of Medicine
School of Medicine
Case Western Reserve University