Happy New Year to all!
After settling back into the start of what we hope will be a great year, it is important to look at our health. January is both Thyroid Awareness Month and Cervical Cancer Awareness Month. We will start with the extremely important thyroid gland that regulates numerous metabolic processes. With the help of iodine, thyroxine (T4) is the primary hormone that is produced and converted into triiodothyronine (T3), the most active form. After our teenage years, thyroid hormone levels may deteriorate and per Starr, 2011, would reportedly affect 50% of the population. It is most often not primary hypothyroidism with traditional elevations in thyroid stimulating hormone (TSH) and low T4 and T3 that is seen but more often patients develop type 2 hypothyroidism which results in normal TSH and low T3 levels accompanied by thyroid symptoms with completely normal TSH/T4 levels. This can be explained by decreased conversion of T4 to T3 resulting in low T3 levels at the cellular levels and TSH doesn’t correlate well with T3 in these instances as it reflects T4/T3 in the pituitary gland/centrally. Some symptoms of thyroid deficiency include thinning hair, weight gain, increased body fat, decreased energy, loss of cognition, depression, menstrual irregularities, and compromised gut motility. The long-term benefits of thyroid optimization have been reported to include a statistically significant reduction in cardiovascular risk factors including lipid levels and insulin sensitization (Krotkiewski, 2000). Cardiovascular disease is the number one killer for women and approximately 50% of patients that have myocardial infarctions will have normal lipids! If your thyroid is not functioning properly then your body is not functioning properly. If you are experiencing any of these symptoms, schedule an appointment so that we may do a thorough evaluation of how well your thyroid is functioning while also assessing for other causes of your symptoms.
All women are at risk for cervical cancer and screening with pap smears should start at age 21. Additional screening with HPV (Human Papilloma Virus) is recommended at age 30. Many patients have other health concerns which include most notably a compromised immune system (either secondary to medication or innate or secondary to HIV). Women that fall in this category will be screened typically yearly and we prefer that first pap smear be done three years after the onset of sexual activity or at least by age 21. HPV (a common virus passed during sexual intercourse) is the main cause of cervical cancer but not the only cause and so, regardless of sexual activity, pap smear screening is recommended for all women. Please see the attached informational sheet from the CDC. As always, pap smear/HPV screening guidelines are just that and may need to be adjusted for your personal history. Finally, our preference in this office is that at age 30 and beyond, pap smear and HPV be done together every 3 years rather than 5 years, as this detection rate for cervical cancer is equivalent to the conventional yearly pap smears that were done annually many years ago. Our goals are the same as yours—early detection of precancerous lesions and doing our best to avoid a diagnosis of cervical cancer.
Thanks for letting us care for you and we hope that you are off to a great 2019!
