Neck On The Line

The Thyroid Rests Neatly Above A Woman’s Collarbone. But When It Goes Haywire, It Can Destroy Every Fibre Of Our Being, From Our Weight To Our Mental Health. So How Come So Many Women Want A Diagnosis? And Why Are Doctors At Each Other’s Throats About How To Treat The Condition? Wh Investigates.

- Virginia Sole-Smith

And though she be but little, she is fierce.” The Shakespearean line from A Midsummer Night’s Dream could describe The Average Woman’s Nightmare – the thyroid. That tiny butterfly-shaped gland in our neck seems to be to blame for why so many of us feel like utter crap: tired. Grumpy. Overweight.

“Current figures of thyroid disorder prevalence in South Africa are lacking. The last known study placed the prevalence of thyroid disorders in South African women at about 0.09 women per 100 000 women,” explains Dr Pitsi Kewana, a GP with a special interest in aesthetic medicine and weight-loss management at the Renewal Institute in Gauteng. “Global prevalence of thyroid disorders ranges from 0.2 percent to 2.6 percent of the population, varying mainly based on the level of iodine sufficiency in the area. Being that South Africa is considered mostly iodine deficient, it’s safe to say local prevalence errs towards the higher figure.”

In the US, roughly 16 million women will, at some point, have a breakdown of the thyroid, which produces hormones that touch every cell and help regulate our metabolisms, our bowels, our brains. More pointedly, one in 10 women will have hypothyroidism, a sluggish gland that doesn’t produce enough hormones to control such functions. Diagnosing the condition is actually simple – a basic blood test determines the amount of thyroid-stimulating hormone (TSH), a substance pumped out by the pituitary gland that regulates thyroid output. Yet doctors have spent decades debating – and are still at odds about – what that amount, or number, should be. A normal TSH typically ranges from 0.4 to 4. So why are some physicians treating patients who have a TSH of 2.5 – smack-dab in normal range – while others hold off until it balloons to 10?