Should You Get Your Thyroid Hormone Levels Checked?

Your thyroid gland controls many aspects in your body. When hormone levels are out of whack you can experience mood changes, heart palapations, and other serious health concerns.

There’s a lot of discussion about how malfunctioning thyroid levels can cause everything from weight and mood changes to heart palpitations. Several mysterious symptoms—from weight changes to irritability to fatigue—can indicate the need to have your thyroid checked. Here’s what you need to know.

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 it produces, though, like insulin, the hormones can be replaced artificially without any noticeable differences,” says Melanie Goldfarb, MD, endocrine surgeon and director of the Endocrine Tumor Program at Providence Saint John’s Health Center and assistant professor of surgery at the John Wayne Cancer Institute, both 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.”

Hyperthyroidism (overactive thyroid) is a condition in which your thyroid gland produces too much of the hormone thyroxine. 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. These are relatively straightforward blood tests.

When the circulating thyroid hormone levels are low (hypothyroidism), the hormone that is measured—TSH—will be 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?

There are many official guidelines from different organizations, but they all give slightly different recommendations, points out Dr. Goldfarb. 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 says. “Additionally, women who are having difficulty conceiving should be tested, though universal screening in pregnancy is still debated.”

Partha Nandi, MD, creator and host of the medical lifestyle television show Ask Dr. Nandi, points out that women are three times more vulnerable to developing thyroid cancer than men. Papillary thyroid cancer is typically found in women of childbearing age. Also, two-thirds of thyroid cancer cases occur between the ages of 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.

Sources
  • 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
  • David Borenstein, MD, founder of Manhattan Integrative Medicine in New York
  • Partha Nandi, MD, creator and host of the medical lifestyle television show Ask Dr. Nandi