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WHEN 37-YEAR-OLD Sandra Blasucci started feeling sick last May, she had no idea what was wrong. “I was hot all the time, my hands , my heart palpitated. My muscles were fatigued. I couldn’t sleep. I was very emotional.” Alarmed, Blasucci, who lives in Port Washington, went to see her family doctor.

“By the physical, they really didn’t know. I said, maybe you should check for Lyme disease.” When the blood test indicated she suffered from an overactive thyroid, Blasucci was surprised. “I had no idea I had a thyroid problem. It didn’t enter my mind.” According to the Thyroid Foundation of America, about 13 million Americans suffer from an overactive or underactive thyroid, and nearly 8 million of them don’t know it.

The thyroid gland is in the lower front portion of the neck. It secretes hormones that control the body’s energy regulation. An overactive thyroid, or hyperthyroidism, occurs when too much hormone is produced, resulting in feelings of anxiety and nervousness, weight loss, heat intolerance and heart palpitations. Symptoms of severe hyperthyroidism, often called Graves’ disease, include bulging eyes and a swollen thyroid.

When lower than normal levels of thyroid hormone are produced, the condition is called hypothyroidism. Symptoms include cold intolerance, constipation, fatigue, weight gain, dry skin and brittle hair. Hypothyroidism can also exacerbate depression.

A thyroid imbalance is easily detected with a blood test that measures thyroid-stimulating hormone (TSH) levels. Because imbalances are five times more common in women than men and usually occur in the childbearing years, Dr.

Irwin Klein, chief of endocrinology, diabetes and metabolism at North Shore University Hospital in Manhasset, recommends that all women undergo thyroid screening on a regular basis. Klein said it’s also important to check for thyroid problems when there is a family history and when planning a family because an imbalance can interfere with fertility.

Screening is also recommended during the year after childbirth. The Thyroid Foundation of America says women have a 5 percent chance of developing either hyper- or hypothyroidism after delivery, which may be a cause of postpartum depression.

But thyroid problems aren’t limited to young people. Hypothyroidism is most common among post-menopausal women and can affect up to 15 percent of all elderly women.

An underactive thyroid is easily treated with a synthetic thyroid hormone that replaces what the thyroid gland is no longer producing. People with hyperthyroidism have three treatment options. In addition to thyroid hormone replacement, anti-thyroid medications are available. While the drugs work for some patients, Dr. Faizur Chowdhury, chief of endocrinology at Good Samaritan Hospital Medical Center in West Islip, said they can adversely affect white blood cells counts, the liver and bone marrow. Surgery can remove up to 80 percent of an overactive thyroid gland, but that is usually reserved for thyroid cancer.

The preferred treatment for hyperthyroidism is a one-time oral dose of radioactive iodine. It is safe-even for people who are allergic to iodine-and effective and rarely has side effects. “The thyroid gland metabolizes iodine for normal function,” Chowdhury said. “You give the iodine attached to a radioactive particle so the thyroid will take this radioactive bound iodine.” The radioactive iodine enters the thyroid and slowly shrinks the gland over a period of weeks or months.

Chowdhury cautions that there is a 10 percent chance that patients can be overtreated. That’s what happened to Blasucci. Her thyroid no longer produces enough hormones, so she now has to take hormone replacement therapy.

Another common thyroid problem is the build-up of fluid, an inflammation or a tumor that forms in the gland. These growths are often referred to as nodules; large growths are called goiters. While the Thyroid Foundation of America says 50 percent of the population will have a nodule at some point during life, most go undetected. Occasionally, the lumps can cause one’s voice to become hoarse or result in difficulty breathing or swallowing.

About 90 percent of all nodules are benign. Ultrasound, a radioactive thyroid scan or fine needle aspiration, can determine the nature of the growth. Most benign nodules are simply observed or treated with synthetic thyroid hormone to prevent them from growing.

If the tests find the nodule is malignant, the prognosis is normally good.

“When diagnosed, the common forms are readily treated and in almost all cases cured,” Klein said.

About 6,000 new thyroid cancer cases are reported each year, according to the Thyroid Foundation of America. Surgery removes the malignant nodule, and Klein said, “In most cases, the surgery itself is curative.” However, some patients may require thyroid hormone replacement or a treatment with radioactive iodine to destroy any residual cancer and prevent its recurrence.