As you read this chapter, you may find it hard to believe that your thyroid can have such powerful effects throughout your body. But the truth of the matter is that adequate thyroid function plays an important role in maintaining good quality of life as we age and staying free from pain and disease.
Our basic bodily functions, general well-being, appearance, energy levels, mental function, emotions, and even our very sanity all depend on adequate thyroid function. Because symptoms that affect physical appearance often show up initially (and can be so distressing), let’s look at them.
- PHYSICAL APPEARANCE -
As we age, we certainly want to take advantage of everything that can keep us youthful, attractive, and svelte. Who needs plastic surgery when maintaining good thyroid function is a cheap, noninvasive way to stave off accelerated aging? When you take a close look at the impact low thyroid function can have on all parts of your body, you’ll realize that you need to take your thyroid seriously in order to age gracefully.
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Since hair and skin are some of our fastest growing tissues, we often notice slowing metabolism in these areas first. Hypothyroidism leads to hair that is dry, brittle, and dull.
It also becomes straighter, finer, and thinner and may even turn gray prematurely. Thin, uneven, patchy gray hair isn’t the look we’re after as we head into our forties or fifties! Another sign of low thyroid function, discovered over a century ago, is the loss of the outer third of the eyebrows. Body hair and eyelashes also often disappear.
Slowing thyroid function takes a big toll on the skin. The first signs are coarse, dry, sallow, pale, unhealthy looking skin, which also may get very itchy (Owen and Lazarus 2003). This can progress to acne, red spots, boils, premature wrinkling, yellowing or grayish skin, rashes, and even eczema or psoriasis. Adequate thyroid function is necessary for good blood circulation, so hypothyroidism results in inadequate blood flow throughout your body. When this happens, blood is preferentially sent to your brain and vital organs to keep essential functions going. Our skin may be our largest organ, but in hypothyroidism it takes a backseat to survival, and as a result, it isn’t properly nourished and replenished by the oxygen that blood provides. Poor circulation can also lead to the development of varicose veins.
Skin can also get puffy and swollen, particularly on the face, arms, and front of the thighs due to fluid building up in the connective tissues. This condition, known as myxedema, is a side effect of slowed metabolism. It’s caused by an accumulation of waste products that aren’t effectively removed from the tissues. Connective tissue is everywhere in the body, so this swelling doesn’t affect just physical appearance; it also impacts the function of the glands, organs, and cells as they become infiltrated with this jellylike substance. In fact, this swelling may affect only internal tissues and organs, without showing any external signs.
When thyroid function is low, the face, particularly around the eyes and jawline, often gets puffy; this, too, is caused by myxedema. Reduced kidney function caused by the general slowing of metabolism also leads to fluid retention, particularly around the eyes and in the hands and ankles.
This is a different type of edema and can be distinguished from myxedema by pressing your finger on it; if it leaves a depression that lasts for a longer period of time than is normal, it’s due to reduced kidney function rather than myxedema. As hypothyroidism progresses, the entire face can develop a coarse look, with swelling or thickening of facial features.
FINGERNAILS AND TOENAILS
Slow-growing, soft, ridged, brittle nails with pale nail beds are a sign of low thyroid function.
The crescent-shaped white area at the base of the nail bed often gets lighter or disappears altogether. This can be due to reduced blood circulation or inadequate protein synthesis, another effect of the general slowing of metabolism in hypothyroidism (Jabbour 2003). Ingrown toenails and fungal infections are also common.
TEETH AND MOUTH
Excessive tartar buildup and cavities can be caused by low thyroid function (Noren and Alm 1983). Excess tarter causes red, swollen, and receding gums (which can be made worse by low estrogen), hence the old saying “getting long in the tooth.” Gum recession isn’t always a reliable sign of hypothyroidism, however, as gum disease due to hypothyroidism can also cause gums to become swollen and overdeveloped and extend down over the teeth instead of receding.
In long-standing hypothyroidism, the mouth can appear large and the lips puffy and coarse.
The color inside the mouth is often pale, and the palate may be more vaulted than usual (Barker, Hoskins, and Mosenthal 1922). Temporomandibular joint syndrome (TMJ syndrome) is also common as hypothyroidism causes problems with muscles and ligaments. In addition, both edema and clenched teeth due to chronic muscular tension can affect the jaw and cause the pain and muscle spasms of TMJ syndrome.
With hypothyroidism, we don’t metabolize food effectively and the calories we consume turn into fat instead of energy. This weight gain is insidious, and neither diet nor exercise resolves it.
When weight gain is caused strictly by low thyroid function and not other endocrine deficiencies as well, fat tends to be symmetrically distributed on the body (Barker, Hoskins, and Mosenthal 1922). When low pituitary function is at the root of low thyroid function, weight gain is generally confined to the area from your abdomen to just above your knees. The skin of a person with hypothyroidism also takes on a flabby look, as overall musculature is affected, too. Bear in mind that being overweight is an issue that goes beyond mere appearances, as it increases your risk of many diseases and health conditions.
FEET AND LEGS
Do you have weak knees, or have you become flat-footed or bowlegged in recent years? All of the ligaments in your body can be affected by low thyroid function. They will tend to relax and can cause conditions like flat feet, weak knees, knock-knees, hyperflexibility of joints, propensity for sprains, and even scoliosis. Early on in hypothyroidism, the knees often get weak. This starts with a feeling of unreliability in the knees, as if your knees might give out if you were to break into a jog or even a fast walk.
The first sign that your ligaments are being affected is often a flattening of the arches of your feet. When they flatten, your foot rotates inward, which can result in painful calluses on the sides of your big toes and sore, aching feet. Another sign of relaxing ligaments is aching palms (Jacobs-
Kosmin and DeHoratius 2005).
Although it can’t be seen, the voice is an obvious indicator of age and health. Due to swelling in the throat, many women with hypothyroidism start to sound more weak and tired. The voice often gets deeper and softer and also more hoarse or nasal. Speech can become deliberate and slow, and as the condition progresses, articulating words may become difficult, causing stumbling over words and slurred speech (Madariaga et al. 2002). These difficulties can stem from swelling of the lips and tongue.
As with being overweight, changes to the voice have impacts beyond the impression you make on others. The swelling of the throat responsible for voice changes also causes difficulties with swallowing, so choking on small objects is common. If the uvula (the little punching bag in the back of your throat) and tonsils swell, this can cause snoring and an inability to breath through the nose.
Not only does low thyroid function result in chronic ear infections due to lowered immune function, it can also result in impaired hearing and abnormal physical ear placement. If long- standing, hypothyroidism can cause the ears can be set lower on the head and protrude more, while also becoming more swollen or thicker than normal. Overall hearing is diminished and excessive earwax is common (Brucker-Davis et al. 1996). Low thyroid function can also cause tinnitus and result in hearing strange noises, such as clicking, ringing, or buzzing sounds or the sound of running water.
As our thyroid function declines, so does our ability to hold ourselves upright. Posture is one of the markers of aging, with stooped and slumped posture being part and parcel of the look of old women. Poor posture may be caused by the fatigue so common in hypothyroidism, or by the bone weakening and osteoporosis that also occur.
This slumping is exacerbated when the abdomen protrudes due to relaxing musculature and swelling of the stomach caused by constipation.
Few things signal aging more than flabby, diminishing muscles. Our muscles are closely tied to the metabolic process, and when it slows, they start to lose their tone and contours. The weight gain we experience at the same time obscures them even more. But again, this goes beyond appearances.
Normal activities will become more difficult as the muscles also get tired easily and often feel heavy, and mobility can be impaired by an increased tendency to stumble or experience muscle cramps (Argov et al. 1988).
Excerpt from THE WOMAN'S GUIDE TO THYROID HEALTH: Comprehensive Solutions for All Your Thyroid Symptoms (New Harbinger Publications)