HOT FLUSHES IN OLDER WOMEN, SLUGGISH THYROID DESPITE NORMAL BLOOD TESTS AND OTHER IMPORTANT HEALTH STORIES
Who would think this week would bring so many interesting stories on health-related topics? Here are just a few highlights that caught my eye:
THYROID STIMULATING HORMONE (TSH) LEVELS MAY BE ASSOCIATED WITH INCREASED HEART DISEASE DEATH IN WOMEN
A new study finds that even high normal levels of TSH or thyroid-stimulating hormone may be associated with increased risk of fatal heart disease in some women. This adds to the growing evidence that when it comes to thyroid blood test results, ONE SIZE DOES NOT FIT ALL. Doctors need to consider each individual patient’s symptoms and health risks before being assured that a high normal TSH result really means all is well with the thyroid. For years women with symptoms of inactive thyroid but high normal thyroid test results (typical symptoms include fatigue, weight gain, high blood pressure, hair loss, trouble with monthly periods and even mental changes) were told they had normal thyroid function and didn’t need treatment with thyroid (or told their symptoms were due to stress or something else altogether).
A number of recent studies now challenge this notion and suggest that for some women with low thyroid symptoms, treating high normal TSH levels with thyroid hormone replacement can be beneficial – and according to this most recent study – even life-saving.
Thyroid stimulating hormone (TSH), also called thyrotropin, is a hormone produced by the pituitary gland. It is released into the blood and acts on the thyroid gland to stimulate more hormone production. A high TSH level is the brains way of alerting a sluggish or underactive thyroid to produce more thyroid hormone. The more sluggish the thyroid, the stronger the brain signal i.e. the higher the TSH level. However doctors should not be falsely assured by high normal TSH levels; for some women this can signal the need for thyroid replacement.
A TSH level should be part of a routine blood test in women as they get older because thyroid disease is so common and can be missed. As always, keep copies of all your test results and medical records. Give your doctor a self-addressed stamped envelope so that you can receive original copies of your test results in the mail. Treating an underactive thyroid is relatively easy and safe so don’t hesitate to be a squeaky wheel and ask for a TSH test if you have symptoms that could be consistent with a thyroid condition.
BISPHOSPHONATE OSTEOPOROSIS DRUGS MAY BE ASSOCIATED WITH IRREGULAR HEARTBEAT
Fosamax (chemical name is alendronate), a medication used to prevent fractures in women with osteoporosis, may be associated with an increased risk of atrial fibrillation, common type of abnormal heart rhythm, according to a recent study.
This is just one of a few recent studies that have described an increased risk of atrial fibrillation in patients taking one of the most commonly prescribed medication types to treat osteoporosis – drugs called bisphosphonates (Fosamax, Actonel and Boniva are all bisphosphonates). Although there is no proof of cause and effect – nor any explanation for why this risk may occur – it seems worth reminding women that any medication we take could have potential side effects.
As always, don’t take any medication unless you carefully consider the benefits and potential risks. Of course all future risks cannot be known so no medicine should be taken “lightly” or without cause. On the other hand, for elderly women at high risk of osteoporotic fracture, the bisphosphonates can provide major protection against future fractures – a very BIG DEAL.
The authors of the study note that more information is needed about whether bisphosphonates could have adverse effects on the atrial tissue of the heart in the long term. Stay tuned while more information is gathered about the potential heart risk, if any, of the bisphosphonates.
INCREASED PHYSICAL ACTIVITY RELATED TO LOWER HEART DISEASE RISK AMONG WOMEN WITH HIGH BODY MASS INDEX
Once again a new study reminds us that if we are overweight or obese, being physically active or FIT will reduce but not eliminate future health risks. This is just one more reminder to all that it is never too late to begin an exercise program and reverse some of the risks of heart disease. Just 30 minutes of walking a day will start to shrink dangerous belly fat (called visceral fat) even if you don’t yet tip the scale.
HOT FLASHES CAN PERSIST IN OLDER WOMEN
A new study finds that 20 % of women continue to experience annoying and sometimes disabling hot flashes for up to 9 years after menopause and 10 % of women continue to experience hot flashes for 10 years or even many years after menopause. This is no small number of women who are suffering when you consider that well over 40 million women are currently in menopause.
We are constantly reminded of the small increased health risk of taking hormones after menopause, but rarely are we told of the potential benefits. When it comes to treating low estrogen symptoms like hot flashes and atrophic vaginitis (dry, thinning vaginal tissue) studies have shown that nothing works as well as a tiny amount of estrogen. We need more studies on the benefits of giving women with persistent hot flashes very low doses of estrogen via a patch or “transdermal” route. There is reason to believe that for some women, a low dose of an estrogen patch can be a safe and potentially heart and bone healthy treatment, and would provide these women with relief of their hot flashes and vaginal symptoms as well.
As always, I welcome your questions and comments on this or any other medical issue or concern.