Are You Having Thyroid Problems?
It's hard to tell if you have thyroid disease. You might feel run down and tired, or have what is known as "brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious, or sweat a lot more than usual. All of these are common symptoms of thyroid disorders.
The thyroid gland regulates many body processes. Women are particularly likely to have disorders that affect the function of this essential hormone-producing gland. Recognizing and treating these conditions can help preserve your health and prevent long-term health problems.
The thyroid gland is located in front of your neck. It has right and left lobes that resemble a butterfly. This gland produces hormones that help control your metabolism, which is how your body uses energy. Disorders that affect thyroid function can either speed up or slow down metabolic processes, which can lead to a wide range of symptoms.
Weight Loss/Weight Gain
Changes in weight can signal an abnormal function of the thyroid gland. Low levels of thyroid hormones (hypothyroidism) can cause weight gain, while unexpected weight loss can signal that too much thyroid hormone is being produced (hyperthyroidism). Hypothyroidism is much more common than hyperthyroidism.
A swollen neck can indicate thyroid disease. Sometimes a swollen neck is caused by a goiter. A goiter is an enlargement of the thyroid gland, which is a butterfly-shaped gland that sits in front of your throat.
As shown here, an enlarged thyroid can be seen as a swelling in the front of the neck. Different thyroid diseases can cause goiters. Goiters can sometimes also result from tumors or nodules that develop within the thyroid.
Changes in Heart Rate
The hormones made in the thyroid gland affect almost every organ in the body, including the heart. Hypothyroidism can cause the heart to beat more slowly, while hyperthyroidism causes a fast heartbeat. Elevated levels of thyroid hormones also can lead to increases in blood pressure and the sense that your heart is pounding (palpitations).
Changes in Mood
Thyroid disorders can affect emotions, energy, and mood. Hypothyroidism can cause symptoms like depression, tiredness, and feeling sluggish. Hyperthyroidism is associated with sleep disturbances, irritability, anxiety, and restlessness.
Hair loss is a common sign of a thyroid problem. Both too high and too low levels of thyroid hormones can lead to hair loss. The hair typically grows back once the condition is treated.
The thyroid affects regulation of body temperature, so those with hypothyroidism often report feeling cold. In contrast, people with hyperthyroidism tend to have excessive sweating and an aversion to heat.
Underactive Thyroid Symptoms
Symptoms and signs of hypothyroidism include:
- Changes or abnormalities in the menstrual cycle
- Dry skin and brittle nails
- Tingling and numbness in the hands or fingers
Overactive Thyroid Symptoms
Other symptoms and signs of hyperthyroidism include:
- Problems with vision
- Irregularities in the menstrual cycle
- Trembling hands
- Muscle weakness
Is It Menopause or Thyroid Disorder?
Thyroid disorders can cause symptoms that are mistaken for those of a woman approaching menopause. Both menstrual cycle changes and mood changes can result from the menopausal transition or from thyroid conditions. Blood tests can determine which of these conditions is responsible for your symptoms. It's also possible to have a combination of the two causes.
When Should You See a Doctor?
Your doctor may recommend tests if you have symptoms or risk factors for thyroid disease. Both hypothyroidism and hyperthyroidism are most common in women over 60 years of age. A family history of thyroid disease increases your risk of developing thyroid conditions.
Neck Check for Thyroid Disorders
Examining your neck in the area of the Adam's apple while you swallow can sometimes detect if your thyroid is enlarged. Swallow while tipping the head back, and examine your neck and the area above the collarbones. If you see any lumps or bulges, see a doctor.
Thyroid Disorders Tests
Blood tests can diagnose many thyroid conditions. Thyroid-stimulating hormone (TSH) is a hormone that controls activity of the thyroid gland. If your TSH is high, this typically signals that your thyroid function is low (hypothyroidism). In contrast, low levels of TSH suggest hyperthyroidism. Your doctor may also order tests to determine the levels of other thyroid hormones. Imaging studies and tissue biopsies are other tests that are sometimes used to evaluate thyroid problems.
Causes: Hashimoto’s Disease
Hashimoto's disease, an autoimmune condition, is the most common cause of hypothyroidism. In Hashimoto's disease the immune system mistakenly targets and damages the thyroid gland, so not enough hormones are produced. Hashimoto's disease tends to run in families.
Causes: Pituitary Gland Problems
Thyroid disease may begin in the pituitary gland. The pituitary is located at the base of your brain. It controls the functions of many other glands in the body, including the thyroid. This gland produces TSH, which signals the thyroid gland to make thyroid hormones.
If there is a problem with your pituitary and not enough TSH is produced, thyroid problems can result. Inflammation of the thyroid (“thyroiditis”) and taking certain medications can also cause low thyroid hormone levels.
Causes: Grave’s Disease
Graves' disease is the most common thyroid disease to cause elevated thyroid hormone levels. This is another autoimmune condition in which the immune system targets the thyroid.
What Is Grave’s Disease?
In Grave's Disease, the immune system attack triggers the release of high levels of thyroid hormones. A swelling behind the eyes is one of the characteristic signs of Graves' disease, as shown in this photo.
A mother’s thyroid may become underactive or overactive in the period following childbirth. This is known as postpartum thyroiditis. An average of 7.5% of women experience postpartum thyroiditis, and most return to normal thyroid function within a year.
Causes: Thyroid Nodules
Thyroid nodules are lumps that are found inside the thyroid gland. These lumps can begin producing high levels of thyroid hormones, leading to thyroid diseases like hyperthyroidism. Large lumps may be obvious, while smaller nodules can be visualized with an ultrasound examination of the thyroid.
Untreated thyroid diseases can, in rare cases, become serious health emergencies. Having too much thyroid hormone in your blood may cause a thyroid storm. Symptoms include:
- Irregular heartbeat (tachycardia)
- Increased body temperature (hyperthermia)
- Rapid muscle weakness
On the other hand, severe thyroid underactivity can cause myxedema, another health emergency. Symptoms of myxedema include:
- Decreased body temperature (hypothermia)
- Mental fog/confusion
- Elevated risk of pneumonia
- Potential coma
Both conditions are considered life-threatening medical emergencies that require immediate medical care.
Treatment for hypothyroidism usually involves taking thyroid hormones in pill form. Common thyroid disease medicines include methimazole (Tapazole) and propylthiouracil (PTU), and carbimazole.
Symptoms usually improve within a few weeks of beginning therapy. Most of those affected will have to take the thyroid hormones throughout their life. Over time, treatment can result in weight loss, increased energy, and lowering of cholesterol levels.
There are several treatments available to fight hyperthyroidism. The best approach can be determined by a doctor, who will likely consider how severe the hyperthyroidism is, as well as a patient's medical history.
Antithyroid medication, which attempts to lower the amount of thyroid hormone produced, is the most common treatment for hyperthyroidism. Many people need to take this medication long-term. You may need other kinds of medication to treat certain symptoms, like tremors or fast heart rate.
Radioactive iodine is a treatment option that destroys the thyroid gland over a period of weeks. This is an oral medication.
Beta blockers don't actually treat thyroid level disorders, but they do improve the symptoms of high blood pressure, rapid heart rate, and heart palpitations.
Hyperthyroidism Treatment: Surgery (Thyroidectomy)
Surgery to remove the thyroid gland is recommended for hyperthyroidism when antithyroid drugs do not work, or if there is severe enlargement of the gland. Surgery can also be used to treat thyroid nodules or tumors. After surgical removal of the gland, most people need to take thyroid hormones in pill form.
Thyroid cancer is not common, and it is among the least deadly types of cancer.
Thyroid Cancer Symptoms
A lump or swelling in the thyroid gland is the most common sign, and only about 5% of thyroid nodules are malignant (cancerous).
Thyroid Cancer Treatment
Some thyroid cancer, but not all, is treated by surgery followed by radioactive iodine therapy or radiation therapy. Thyroid cancer is almost never treated with external radiation.
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