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Your thyroid and you: Q&A with Dr. Elizabeth Pearce, part two

Elizabeth N. Pearce, M.D., M.Sc.
Boston University School of Medicine

An Associate Professor of Medicine at Boston University School of Medicine, Dr. Elizabeth Pearce recently took some time from her work at Boston University School of Medicine to talk more about our thyroid health, and to discuss some of her current interests in this area of medicine. This Q&A is part two in a two part article for Examiner.com.

Q: Now more than ever the thyroid plays a very significant role in women’s health. Do you think that there has been environmental or lifestyle changes that is causing more women, especially younger women, to be diagnosed with thyroid problems? Or is medical technology, and lab results, getting that much more effective in detecting thyroid issues?
A: In terms of the thyroid and the environment – there are over 100 different chemical compounds that have been possibly linked to thyroid dysfunction, but this is something that we are just starting to look at. There are a lot of theories but so far limited evidence. There’s a whole field of endocrine disruptors that has emerged in the last two decades.

In terms of medical imaging – I think that the increased frequency of imaging is one of the rising incidences of thyroid nodules and cancer. Many thyroid nodules are now found incidentally through imaging obtained for other reasons.

Q: I understand that one of your interests includes iodine in pregnancy and lactation. How does iodine affect pregnancy and lactation?
A: You need iodine in the diet to make thyroid hormone. And in pregnancy you need more iodine to maintain normal thyroid function. The requirements stay up in the postpartum period because iodine is secreted into breast milk for the baby’s iodine nutrition. So an important recommendation for pregnant and breastfeeding women in the U.S. is to take a supplement containing 150 mcg of iodine a day. Not all prenatal vitamins contain this so it’s important to check labels.

Q: What is the history and direction of thyroid medication?
A: It hasn’t changed that much since the 1940’s when levothyroxine was first marketed.

Q: Is there anything we can do to our diet to aid in thyroid function?
A: As already noted, in the U.S. women who are pregnant or breastfeeding in the United States may be at risk for mild iodine deficiency. They should take a supplement containing 150 mcg/day iodine. Because milk is a major source of iodine in the U.S. diet, vegans may also be at risk for low iodine intake, and should consider taking an iodine-containing supplement with 150 mcg iodine daily. There is no need to take larger quantities of iodine.

Q: Why is it so important to understand our risk factors for poor thyroid health?
A: I think it’s useful to know your family history of thyroid disorders because they are often hereditary.

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