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EDITIONS
 Sunday, 22 December, 2002, 00:05 GMT
Thyroid problems 'missed by doctors'
Woman with her head in her hands
Tiredness can be indication of thyroid disease
Feeling run down or losing weight may not be seen as signs of a serious medical problem, but both can be signs of thyroid disease.

Many patients say their condition is missed because doctors fail to consider the diagnosis.


It took several months for Betty Nevens to be correctly diagnosed as having an over-active thyroid 10 years ago.

"I woke up one morning with both eyes blood red," she told BBC News Online.

"I went to the doctor and he treated me for conjunctivitis. My eyes cleared, but they became puffy at the top and the bottom.

GPs see a lot of people with these symptoms

Dr Mark Vanderpump, Royal Free Hospital
"I went back to the doctor and was given some stronger conjunctivitis pills."

Mrs Nevens, from Leeds, then went on a low-fat diet. She lost a stone, but continued to lose weight even after she stopped dieting.

"But I didn't think that was a problem even though I had a huge increase in appetite. I was also doing things like decorating non-stop. Other people also noticed I had a slight tremor."

Control

She went back to the doctor when she developed breathing problems and was treated for a chest infection.

It was five months after she first became ill that a friend of Mrs Nevens, now 43, who happened to be a doctor, suggested she might have an over-active thyroid, or hyperthyroidism.

After a blood test confirmed the diagnosis, she was given the drug carbimazole to bring her thyroid under control.

Eye problems, rapid weight loss and being unable to sit still are all symptoms of an over-active thyroid.

Feeling run down, weight-gain and brittle hair and nails can be signs of an under-active thyroid. Both can be treated.

Getting better

Mrs Nevens, who works for the British Thyroid Foundation, said: "The vast majority of people who contact us have been treated for something else previously.

"We're trying to raise awareness of thyroid conditions with members of the public and the medical profession."

Dr Mark Vanderpump, an endocrinologist at the Royal Free Hospital in London, said there was such a wide range of symptoms of thyroid disease that it could be difficult for GPs to spot.

"GPs see a lot of people with these symptoms," he said.

"But it doesn't take a lot to send of a blood test."

He added doctors were becoming more aware of thyroid disease.

"It is getting better and there is greater public awareness."

Palpitations

Some patients with ME/chronic fatigue syndrome are suspected of having a thyroid problem.

Dr Vanderpump said: "Thyroid disease can be invoked as a cause, especially if someone has a borderline test."

Problems can arise when the blood test, which measures the level of TSH, or thyroid stimulating hormone.

If the results are borderline, either just above or below normal, doctors can decide there is not a problem - even if the patient feels ill.

And there are fears that treating people who fall into that bracket with thyroxine could lead to symptoms such as nervousness, sweating and palpitations.

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