Your Thyroid and You: Q & A with Endocrinologist Dr. Lara Paraskos

By Christopher Pearson

 

January is National Thyroid Awareness Month. Most people have heard of the thyroid gland, but few know much about it other than its location. And for those who do not know where it is located, the thyroid is found at the base of your neck, right above the collarbone.

One of South Florida’s top endocrinologists, Dr. Lara Paraskos of Endocrinology Associates, P.A. in South Miami, tells us more about this interesting organ and a condition known as hypothyroidism.

Q: What is the thyroid?

A: The butterfly-shaped thyroid organ is responsible for the rate (how fast or slow) of certain functions in the body, such as digestion, hair growth, skin turnover, heart rate and temperature regulation.   

Q: What is hypothyroidism?

A: Hypothyroidism is an underactive thyroid. Patients with hypothyroidism may experience fatigue, cold intolerance, constipation, weight gain, hair loss and brittle nails. The symptoms of hypothyroidism can be nonspecific and overlap with many non-hormonal issues such as anemia, depression and sleep deprivation. It is important for people with these symptoms to speak with their primary care doctor and be evaluated for additional underlying conditions.

Q: What causes hypothyroidism, and is it common?

A: Hypothyroidism affects nearly 10 million Americans and is more common in women than in men. In fact, close to 10 percent of all women will have some degree of thyroid hormone abnormality. The most common cause of hypothyroidism in the United States is Hashimoto’s thyroiditis, an autoimmune condition. In people with Hashimoto’s disease, the body produces antibodies that attack the thyroid, causing inflammation and, ultimately, destruction of the gland. Other causes of hypothyroidism include surgery, radiation and medications such as lithium and amiodarone,

Q: How are thyroid disorders diagnosed?

A: We look for thyroid disorders by checking the thyroid stimulating hormone (TSH). This hormone is released by the pituitary gland to regulate the amount of thyroid hormone (T4 and T3) produced by the thyroid gland.

Q: If lab tests are normal, could a person still have a thyroid problem?

A: No! The TSH lab assay is reliable, and, with few exceptions, there are no false negatives. I do not routinely check T3 and T4 levels. I will check them at initial diagnosis to rule out extremely rare conditions.

Q: Should I take a thyroid supplement?

A: I do not usually recommend supplements. They are not regulated by the FDA and when it comes to the thyroid, some supplements can actually hurt you! Most thyroid supplements contain large doses of iodine. Anything in excess of 150 mcg per day may worsen hypothyroidism and be dangerous. 

Q: Is there a specific diet you recommend for hypothyroidism?

A: This is a common question from my patients. Many specifically ask about a gluten-free diet. There is a possibility that eating a gluten-free diet will decrease Hashimoto’s antibody levels, but we do not know what this translates into clinically. Unfortunately, nobody with Hashimoto’s disease can cure themselves with lifestyle changes.

Q: How is hypothyroidism treated?

A: Fortunately, we have excellent treatments for hypothyroidism. The most commonly prescribed medication is Synthroid (levothyroxine sodium tablets), a synthetic version of the T4 hormone produced by the thyroid. We sometimes treat with desiccated animal thyroid. No studies confirm the advantage of one type of treatment over another. Therefore, treatment should be individualized to patient response to therapy and patient preference.

Q: Why did you become a doctor?

A: I became interested in becoming a doctor in seventh grade when my teacher, Mrs. Maria Gonzalez, assigned a project that tasked students with researching the steps to become a member of a specific profession. After attending Emory University for four years to earn my undergraduate degree, I spent 10 years at the University of Miami in medical school and completing my residency and endocrinology fellowship. I am very grateful to Mrs. Gonzalez for sparking my interest in becoming a doctor.  

Endrocrinology Associates, P.A. is located at 6141 Sunset Drive, Suite 402, in South Miami. For more information, call 305-665-2300 or visit www.endofl.com.

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