Getting Past Insurance Problems:

A Guide for Patients with Thyroid Disorders

Making it through each day can sometimes be a challenge for patients with thyroid disorders. Managing symptoms like the anxiety and restlessness of hyperthyroidism or the crushing fatigue and depression of hypothyroidism can be draining in and of itself, and dealing with doctors, physicians, and even friends and loved ones who don't always understand the impact of these diseases can add insult to injury.

On top of all of these issues, a growing number of thyroid patients have begun to encounter difficulties when dealing with HMOs, private health insurance companies, or government health agencies. Common complaints include denials of service, rejection of treatments deemed to be too "experimental," or refusal of coverage for treatment of symptoms and health problems that result from thyroid problems.

If you or a loved one has encountered these kinds of difficulties, don't panic and don't despair. Although it can be a long, challenging process, it is possible to negotiate with your health insurance provider and achieve a successful outcome. This week, we'll take a look at some methods you can use to help persuade your insurance carrier to provide better coverage for your thyroid disorder.

Navigating the Maze of Health Insurance

Over the course of the last several decades, the health insurance industry has gone increasingly complex. With the rise of HMOs and managed care in the 1980s, more insurance companies began to focus on the costs of health care -- and devising ways to minimize their own payouts to patients.

Supporters of the insurance industry argue that a focus on the cost-effectiveness of common treatments benefits everyone by keeping the price of health care down. However, opponents of this approach contend that a growing number of the decisions made by health insurance companies seem to be based on dollars and cents, rather than compassion or genuine concern for the patients' best interests.

This whole debate grows even more complicated in the context of treatment for thyroid disorders. The thyroid gland -- and the endocrine system as a whole -- is enormously complex, and scientists are continuing to work toward unraveling the mysteries of its function and role in the body. Compared to many other organs, the thyroid gland was discovered relatively recently, and it is only in the last several decades that the full spectrum of thyroid disorders have been identified and described in the research literature.

Another problem is the fact that thyroid disorders can cause an extremely broad array of symptoms. A patient with hypothyroidism, for example, may also be grappling with obesity, chronic fatigue, and depression, to name just a few. If not directly caused by the thyroid imbalance, all of these symptoms are surely exacerbated by improper thyroid function. Still, these are exactly the kind of broad, indistinct symptoms that insurance companies often balk at covering.

Generally speaking, most thyroid patients typically experience little or no difficulty receiving full coverage for the symptoms that are directly related to their diagnosis. However, once you move outside of that small circle of clearly-defined symptoms, you are more likely to run into trouble.

Acting As Your Own Advocate

So, what can you do if your insurance company, HMO, or government health care plan has refused to pay for a thyroid-related disorder? Surprisingly enough, there are many avenues for recourse if you have been denied coverage. Here are some tips that can help you work through this challenge.

• Document everything. It's absolutely vital that you record every interaction with your insurance company. Get a notebook or binder and use it to collect documentation. Every time that you speak with a company representative over the phone, make a detailed factual journal entry about it, including the time, date, and name of the person you spoke with, as well as a concise account of what happened in the call.

• Practice detachment. It's easy to get emotional when your health and well-being are on the line, but your campaign is likely to be much more effective if you can stay as calm and poised as possible. Imagine yourself as a lawyer or mediator who wants the best outcome for the case, but who isn't personally impacted by it.

• Don't take 'no' for an answer. If you're turned down, it's not the end of the world. The company's policies are open to interpretation, and if you persevere, you may get a more favorable reading from another company representative.

• Take the escalator. Each time that a customer representative denies coverage, take your case to the next level in the organizational chain. Once you sense you've reached an impasse, calmly request to be transferred to the supervisor or manager. Keep escalating your case until you get the outcome you want, or until you reach the executive level. If you've talked to the CEO and you're still not satisfied with the results you've gotten, it may be time to consult with an attorney.

For Further Reading

• http://www.smartmoney.com/consumer/index.cfm?Story=20020509

• http://www.cnn.com/2007/HEALTH/07/19/patient.insurance/index.html

Thyroid Disorders and Aging: Common Problems and Challenges

The prospect of growing older brings with it an array of health challenges. As our organs, tissues, and other bodily systems age, their ability to function properly can decline. Even in the absence of a specific illness, disease, or injury, seniors’ overall quality of life can be negatively impacted if these small, gradual changes are not monitored and addressed.

Older men and women stand a much greater chance of developing thyroid disorders. In fact, health data show that seniors comprise the vast majority of those diagnosed with hyperthyroidism, hypothyroidism, and other common thyroid problems.

Although thyroid problems are rarely fatal and respond well if treated properly, prompt and accurate diagnosis can often be difficult in older men and women. A recent study conducted by scientists at the Montefiore Medical Center and Albert Einstein College of Medicine found that the early signs of thyroid disorders are often overlooked in elderly patients, and are sometimes mistaken for normal signs of aging.

As a result, it’s particularly important for older men and women -- as well as their loved ones and family members -- to stay aware of common thyroid symptoms and to alert their physicians at the first sign of any possible problems. This week, we’ll take a closer look at the issue of thyroid disorders in the elderly.

How Often Do Thyroid Disorders Impact the Elderly?

Although people in every phase of life can suffer from hypothyroidism, hyperthyroidism, and other forms of thyroid disease, these disorders are most common among men and particularly women over the age of 60. According to recent health statistics, as much as twenty percent of the female elderly population may be suffering from thyroid imbalance, with an estimate of fifteen percent applied to their male counterparts. Many of these thyroid disorders -- some believe more than half -- may be undiagnosed.

The exact causes of the high prevalence of thyroid disorders in the elderly are not yet known. Many researchers believe that the problem stems from a combination of the hormonal and endocrine system changes that can mark the later years, as well as a general decline in the body’s ability to function properly with advancing age.

What are the Unique Risks of Thyroid Disorders in the Elderly?

Thyroid disorders pose a significant health risk regardless of the patient’s age. However, in the elderly population, diseases such as hypothyroidism, hyperthyroidism, Grave’s disease, and other disorders can have dire consequences, particularly if they are left untreated.

Hypothyroidism, which results from an underactive thyroid gland, is linked with a wide array of negative health impacts among older men and women. Mental illness is one of the most serious concerns.

It is estimated that as many as one-quarter of all men and women over the age of 65 have some form of mental illness or disorder, and that thyroid problems may play a part in causing mental illness or exacerbating existing mental disorders, including dementia and confusion. Other health problems that have been linked with hypothyroidism in the elderly population include obesity, hardening of the arteries, higher cholesterol, and hypertension.

Though less common than hypothyroidism, hyperthyroidism also impacts older men and women. Left untreated, it can result in potentially serious health problems, including heart palpitations, fatigue and weakness, decreased mobility, congestive heart failure, and weight loss.

The Treatment of Thyroid Disorders in the Elderly

Generally, most thyroid disorders respond well to consistent treatment, and this trend holds true with older men and women, as well. However, because of the unique health challenges facing the elderly as a result of the natural aging process, there are some considerations that have to be addressed when devising an effective treatment plan.

For example, some common forms of treatment for hypothyroidism can aggravate pre-existing heart conditions, for which elderly men and women are at greater risk than their younger counterparts. Post-menopausal women who are being treated with hormone replacement therapy may have to have their medications adjusted. Also, in general, lower dosages of medication are typically needed to treat elderly men and women with thyroid disorders.

Symptoms to Look Out For

If you or an elderly friend or family member experiences any of these symptoms, talk to a licensed medical professional as soon as possible.

• Weight loss or gain
• Confusion
• Sensitivity to heat or cold
• Constipation
• Dry, itchy skin
• Fatigue
• Hearing loss
• Nervousness
• Anxiety
• Depression
• Apathy
• Appetite changes

For Further Reading

• http://www.postgradmed.com/issues/2003/05_03/mohandas1.htm

• http://thyroid.about.com/od/gettestedanddiagnosed/a/borderline.htm

Weathering a Thyroid Storm:

The Diagnosis and Treatment of a Form of Hyperthyroidism

Although many thyroid disorders have the potential to pose a serious health risk, most are classified as chronic conditions that respond well to long-term treatment.

Typically, thyroid conditions emerge gradually, with symptoms developing slowly over an extended period of time. It can take months or even years for patients to notice signs indicating that there may be a problem. After diagnosis, most thyroid disorders can be well-controlled with strict adherence to a prescribed treatment plan, allowing patients to enjoy a relatively normal life free of serious health problems.

However, a small sub-class of thyroid illnesses poses more immediate health risks and often requires emergency medical intervention. Chief among these is the sudden-onset thyroid crisis that is known as a ‘thyroid storm.’ This week, we’ll take a look at this rare but dangerous thyroid disorder, exploring its causes and treatments, tell-tale symptoms, and the steps you should take if you suspect that you or a loved one may be experiencing a thyroid storm.

What is a Thyroid Storm?

Like most other thyroid disorders, the illness known as a ‘thyroid storm’ involves an imbalance in the production and distribution of thyroid hormones within the body. However, unlike most other thyroid disorders, a thyroid storm occurs suddenly, resulting in a significant hormonal imbalance that can be life-threatening if not treated immediately.

In many ways, a thyroid storm is similar to an advanced case of hyperthyroidism, which is the medical term for an overactive thyroid gland. In hyperthyroidism, the thyroid gland produces too much thyroid hormone. The resulting imbalance leads to symptoms such as weight loss, anxiety, ‘jittery’ feelings, and excessive energy.

A thyroid storm can be described as a case of severe, sudden hyperthyroidism. The physiological malfunctions that can take months or years to develop in classical hyperthyroidism occur in a much-compressed time span, causing many of the symptoms and secondary health problems associated with hyperthyroidism to occur all at once. As a result, the intensity and severity of the symptoms are increased considerably, often resulting in an emergency health crisis that can prove fatal if not treated properly.

What are the Symptoms of a Thyroid Storm?

To a large extent, the symptoms of a thyroid storm resemble the symptoms of hyperthyroidism, although they are typically much more intense. However, some of the tell-tale symptoms that indicate the onset of a thyroid crisis include: a very high fever (up to 105º), heart palpitations, rapid heart rate, shortness of breath, chest pains, a rapid increase in blood pressure, dementia or confusion, weakness, heavy perspiration, and nausea and vomiting. In most cases, the sudden onset of a wide range of serious symptoms at once will make it clear to bystanders that the affected individual is in need of emergency treatment.

Who is at Risk for a Thyroid Storm?

Statistically speaking, thyroid storms are very rare occurrences. Individuals without a prior history of thyroid problems almost never experience thyroid storms. Patients who have a family history of thyroid disorders or have undergone treatment for thyroid disorders -- especially hyperthyroidism -- stand the greatest chance of being struck by a thyroid storm.

Specific risk factors include:

• discontinuation or inconsistent use of hyperthyroidism medication
• excessive treatment of hypothyroidism, resulting in overproduction of thyroid hormone
• radioactive iodine treatment for a thyroid disorder
• a severe illness or health crisis, such as infection, disease, heart attack, or stroke, usually in a patient with hyperthyroidism

How are Thyroid Storms Treated?

Effective intervention and treatment of a thyroid storm involves returning the level of thyroid hormones in the body to normal levels as soon as possible. For this reason, it is vital to ensure that patients who may be experiencing a thyroid storm seek emergency treatment as soon as possible.

The standard treatments that are used to return thyroid hormone levels to the normal range include prescription compounds such as PTU, methimazole, sodium iodide, potassium iodide, and Lugol’s solution. Depending on the specific symptoms that the patient is experiencing, other treatments may be needed to control other problems such as heart palpitations and high blood pressure.

In the past, thyroid storms were often fatal. Today, however, the survival rate associated with these crises has improved significantly. The key to successful treatment is seeking emergency care at the first sign of a possible problem.

If you suspect that you or a loved one may be experiencing a thyroid storm, seek emergency medical treatment immediately. Be sure to check back each week for more of the news and information that can help you achieve and maintain optimal thyroid health.

Are you tired, cold, cranky?

Is what your feeling part of the normal aging process or could it be low thyroid hormone, hypothyroid? Read more about hypothyroidism. Blood tests can help to diagnose this thyroid disorder.

Can low thyroid affect my weight loss efforts?

If you are fighting the battle to lose weight, and those efforts are stagnant or non-producing, a blood test might help to determine if there is another issue that is disabling your weight loss efforts. If you are doing all the right things and you can't seem to lose weight, your problem could be your thyroid. Thyroid replacement hormone is inexpensive and available in generic.

Thyroid Examinations are an Important Aspect of the Diagnosis of a Thyroid Disorder

A thyroid examination is an important tool that surgeons and endocrinologists use in the diagnosis of a thyroid disorder. A thyroid examination should be performed by the hands of an experienced physician.

Take a moment to view this video for an illustration of the thyroid examination process.

Defining Parathyroid Disorders: Origins, Symptoms, Diagnosis, and Treatments

Finding out about the inch-long thyroid gland’s outsize role in maintaining equilibrium in the body often comes as something of a shock to patients newly diagnosed with thyroid disorders. What may be even more surprising is being diagnosed with a disorder of the parathyroid glands, four pea-sized glands that are attached behind the thyroid gland itself.

Despite their tiny stature, the parathyroid glands also play a key role in maintaining health and well-being. Although problems originating in the parathyroid glands often do not have the wide-ranging health impact associated with disorders of the larger thyroid gland, they can still cause significant health challenges for patients.

Still, the general public’s awareness of parathyroid gland disorders tends to be very low. In fact, many doctors report that it’s not uncommon for their patients to be unaware of the parathyroid glands’ existence before being diagnosed with a disorder of these small glands. Medical science, as well, was slow to recognize the parathyroid glands -- they were the last major organ of the human body to be discovered and described in the scientific literature, with the first study identifying the glands published in 1880.

This week, we’ll take a look at parathyroid thyroid gland disorders, focusing on common symptoms, causes, diagnosis procedures, established and emerging treatments, and disease outcomes.

What are the Parathyroid Glands?

In spite of their close proximity to the thyroid gland and a similar-sounding name, the parathyroid glands are actually quite different from their larger neighbor. In fact, they diverge significantly from the thyroid gland in both structure and function.

Unlike the follicle-based structure that defines the thyroid gland, the parathyroid glands are comprised of a mass of densely-packed cellular tissues. Furthermore, while the thyroid gland has a wide range of regulatory functions within the larger endocrine system, the parathyroid glands’ primary task is the regulation of certain types of calcium within the body.

The majority of people have four parathyroid glands, but it is estimated that as much as 10% of the general population has more, with 6, 7, and 8 parathyroid glands being the most commonly identified deviation from the norm. Although the structural differences between the two make it easy for parathyroid gland cells to be differentiated from thyroid gland cells under a microscope, the glands can be quite difficult to distinguish with the naked eye or using common medical imaging techniques, which can pose a challenge during diagnosis or surgery.

What are the Major Parathyroid Gland Disorders?

Like the thyroid gland, most parathyroid disorders fall into one of two broad categories, both of which are related to the production of a chemical compound known as parathyroid hormone (PTH).

Overactive parathyroid glands that produce too much parathyroid hormone result in a condition known as hyperparathyroidism. Patients diagnosed with hyperparathyroidism often experience excess calcium levels in the blood. This, in turn, can disrupt the regulation of phosphorous in the body, as well as the bones’ intake of calcium. In some cases, it also results in kidney stones. In most cases, hyperparathyroidism is caused by a benign tumor or growth on the parathyroid glands. In rare instances, the disorder results from cancerous cell growth.

Patients whose parathyroid glands produce too little parathyroid hormone are diagnosed with the disorder known as hypoparathyroidism. The primary outcomes of this disorder are blood calcium deficiency and excess phosphorous levels. These mineral imbalances can result in other problems, such as bone density loss, brain calcifications, and cataracts.

Most cases of hypoparathyroidism are caused by neck or throat injuries. In some cases, hypoparathyroidism can result from the treatment of a thyroid disorder, such as thyroid surgery or radioactive iodine treatment.

Diagnosis and Treatment of Parathyroid Gland Disorders

The symptoms associated with parathyroid disorders are often so subtle as to be imperceptible to the patient. Often, they are diagnosed with the help of blood screening tests. When doctors note an unusual value in calcium or phosphorus levels, the parathyroid glands are often viewed as possible culprits. Further testing and analysis of the patient’s medical history can usually help finalize the diagnosis.

When identified quickly, the prognosis for treatment of parathyroid disorders is typically very good. Most current treatment options involve regulating calcium and phosphorus levels in the body with prescription drugs and mineral supplements. In some cases, surgery is necessary, particularly for patients with overactive parathyroid glands.

However, in cases in which the diagnosis of the parathyroid disorder has been delayed, the patients may be faced with irreversible health problems, such as dental problems, cataracts, and bone loss.

If you have a personal or family history of thyroid disorders, it is important to alert your doctor so that you can undergo parathyroid disorder screening as part of your ongoing medical care. Be sure to check back each week for more news to help fine-tune your thyroid health.

For Further Reading

• http://endocrine.niddk.nih.gov/pubs/hyper/hyper.htm
• http://www.nlm.nih.gov/medlineplus/ency/article/000385.htm
• http://www.nlm.nih.gov/medlineplus/parathyroiddisorders.html