There’s a lot of chatter out there about how a malfunctioning thyroid levels can cause everything from weight changes to mood changes to heart palpitations.
What is your thyroid?
Your thyroid gland controls your body’s metabolism and is one of its most important endocrine organs. “You can’t live without the hormones (TSH) it produces, though like insulin, the hormones can be replaced artificially without any noticeable differences,” says Melanie Goldfarb, MD, MS, FACS, endocrine surgeon and director of the Endocrine Tumor Program at Providence Saint John’s Health Center in Santa Monica, California and assistant professor of surgery at the John Wayne Cancer Institute in Santa Monica, California. “Some functions that a thyroid helps regulate are the body’s temperature, how fast food moves through the GI, how sugar is used up (metabolism), and how fast and forcefully the heart beats.”
According to the Mayo Clinic, hyperthyroidism (overactive thyroid) is a condition in which your thyroid gland produces too much of the hormone thyroxine. “Hyperthyroidism can accelerate your body’s metabolism significantly, causing sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability,” the article states.
If your thyroid is underactive, called hypothyroidism or low thyroid level, it can also cause high cholesterol. “Thyroid hormone is needed to make cholesterol and get rid of cholesterol you don’t need,” says David Borenstein, MD, founder of Manhattan Integrative Medicine in New York. “Patients with low thyroid levels have difficulty breaking down and removing LDL (bad cholesterol), causing LDL levels to rise in the bloodstream.” In addition, he says hypothyroidism also causes constipation by weakening the contraction of the muscles in the digestive tract, causing the stool to move slower.
How is a thyroid problem diagnosed?
The main thyroid test used by many physicians measures a pituitary hormone called thyroid stimulating hormone, or TSH, according to Dr. Borenstein. Elevations in the TSH level can point to an underactive thyroid, he says. “In addition to the TSH test, integrative hormone experts frequently also test the circulating levels of thyroid hormones with the Free T4 and Free T3 test,” Dr. Borenstein adds. The thyroid test is a simple blood test.
When the circulating thyroid hormone levels are low, that is called “hypothyroidism” though actually the hormone that is measured, TSH, is high, says Dr. Goldfarb. “This means that your body is not producing enough thyroid hormone to keep up with all processes it needs to fuel, so your body can feel like its slowing down. The severity and symptoms vary between individuals, the extent of hormone depletion, and the duration of untreated hypothyroidism,” she explains.
Who should get a thyroid test?
According to Dr. Goldfarb, there are many official guidelines from different organizations, but they all give slightly different recommendations. They range from no routine screening to screening everyone over the age of 35 every five years, to yearly screening in older patients. “However, certain populations of patients, such as those with comorbidities or other autoimmune diseases, should likely be screened,” Dr. Goldfarb continues. “Additionally, women who are having difficulty conceiving should be tested, though universal screening in pregnancy is still debated.”
To that end, Partha Nandi, MD, creator and host of the Emmy-award winning medical lifestyle television show Ask Dr. Nandi, says females are three times more vulnerable to developing thyroid cancer than males. Papillary thyroid cancer is typically found in women of childbearing age. Also, two-thirds of thyroid cancer cases occur between ages 20 and 55.
“Because so many of the symptoms of an impaired thyroid can also be attributed to menopause or simply getting older and since not everyone experiences symptoms at all, testing is really the best way to know if your thyroid is functioning properly,” Dr. Nandi says.