18 Things Your Doctor Wants You to Know About Thyroid Problems
More than 20 million Americans will get hit by thyroid disease or disorder—and 60 percent of them won't even realize that's what is making them sick. Here's what doctors need you to know.
What is a thyroid gland?
"The thyroid is a butterfly-shaped organ that sits in the front of the neck," says Archana Durga Narla, MD, an endocrinologist at Crystal Run Healthcare in West Nyack, New York. "It makes thyroid hormones [mostly triiodothyronine (T3) and thyroxine (T4)] which is used by multiple organ systems throughout the body."
How important are thyroid hormones?
The hormones your thyroid produces are carried through the bloodstream throughout your body, explain experts at the American Thyroid Association, and they direct vital body systems like your metabolism, your heart rate, your brain, and your muscles. They also help stimulate and regulate how efficiently your body uses energy.
Hyperthyroidism is one of the most common thyroid diseases
According to the National Institutes of Health (NIH), 1.2 percent of people in the U.S. suffer from hyperthyroidism (an overactive thyroid)—roughly one in 100 people. Women are two to 10 times more likely to have hyperthyroidism than men, and it's most commonly caused by an autoimmune response from the body. The immune system attacks the thyroid, leading the gland to behave erratically, says Dr. Narla. Learn the simple habits that can help keep your thyroid healthy.
Graves' disease is the most common cause of hyperthyroidism
The NIH reports that Graves' disease affects 1 in 200 people—most commonly those between the ages of 30 and 50; again, women are more susceptible to the disease than men. Graves' disease is a type of autoimmune disease that attacks the thyroid. People with a family history of Graves' or a related autoimmune condition such as rheumatoid arthritis, lupus, type 1 diabetes, or celiac disease may later develop Graves' disease. Read about the autoimmune disease that's striking millennials in record numbers.
The symptoms of hyperthyroidism can vary
"Hyperthyroidism can present with symptoms ranging from fatigue to irritability," says Erik Polan, DO, assistant professor at Philadelphia College of Osteopathic Medicine. "Common symptoms also include a goiter (an enlarged thyroid gland), irregular heartbeat (atrial fibrillation), diarrhea, insomnia, weight loss, tremors, and heat intolerance."
Hyperthyroidism can make you may feel energized
"Patients with hyperthyroidism often have increased energy due to a more active metabolism," says Dr. Narla. "But this is not sustainable, so over time patients often develop fatigue as well." Check out these 13 thyroid facts you should definitely know.
Hyperthyroidism usually has three treatment options
In order to manage hyperthyroidism, doctors and patients can choose between three different approaches. Finding the right one will depend on the underlying cause of the disorder, the patient's preference, and any potential risks based on the patient's health history, says Dr. Narla. The options include medication (methimazole and propylthiouracil are two examples) to control thyroid function, surgery on the gland, or a procedure called radioactive iodine ablation, which kills a portion or all of the thyroid.
Severe cases can turn into a thyroid storm
The sudden overproduction of thyroid hormones is called a thyroid storm, according to the U.S. National Library of Medicine, and requires hospitalization to manage the condition. Symptoms include a high fever over 100.5˚F, diarrhea, vomiting, and, in extreme cases, fainting and loss of consciousness. A thyroid storm can also result from treating the condition with radioactive iodine, especially in patients with Graves' disease. These are the 13 silent thyroid symptoms to watch out for.
The other extreme: hypothyroidism
This is the opposite of a hyperactive thyroid. Hypothyroidism means the gland is slowing down and failing to produce enough hormones. The NIH says that 4.6 percent of the U.S. population five out of 100 people suffer from mild hypothyroidism. As with hyperthyroidism, women are more prone to the condition, particularly women over the age of 60. Again, the usual cause is the body's immune system attacking the thyroid by mistake, says Dr. Narla, resulting in the destruction of thyroid cells and its enzymes needed to make thyroid hormones.
Hashimoto's disease is the leading cause of hypothyroidism
The most common autoimmune disorder that leads to hypothyroidism is called Hashimoto's disease, according to the NIH: It hits five out of 100 people in the U.S. between the ages of 40 to 60. Like Graves', women are at higher risk, and having an autoimmune disease such as rheumatoid arthritis, lupus, type 1 diabetes, or celiac disease (to name a few) worsens your odds. Why some people develop Graves' disease versus Hashimoto's disease is still largely unknown, but researchers think it's a combination of genes and potentially certain viruses. These are the 12 silent signs of Hashimoto's everyone should know.
The symptoms of hypothyroidism can be mood-related
"Given that the thyroid plays a role in many different metabolic processes in the body, hypothyroidism will present with symptoms consistent with a slowing down such as cold intolerance, tiring easily, dry skin, constipation, memory changes, and depression," Dr. Narla says. Dr. Polan adds that an irregular menstrual cycle, in addition to these symptoms, could also point to a thyroid issue. Find out what foods thyroid experts avoid eating.
You can be born with hypothyroidism
Congenital hypothyroidism is when infants don't produce enough thyroid hormones. This most often occurs when a baby's thyroid gland fails to develop properly in utero. Congenital hypothyroidism affects roughly one in 2,000 to 4,000 newborns and is twice as common in females versus males. While some infants with the condition may sleep more than usual and suffer from constipation, these traits are common in many newborns. That's why doctors will do a heel-prick blood test a few days after birth to look for any thyroid issues.
Medication is the most common treatment for hypothyroidism
In order to replace missing thyroid hormones, says Dr. Narla, doctors will prescribe a medication like levothyroxine, which can shore up hormone levels. Find out how to tell if you're suffering from a hidden thyroid problem.
Hypothyroidism can lead to a coma
In a rare and life-threatening situation, extremely low levels of thyroid hormones can induce what's known as a myxedema coma. This typically occurs in response to surgery, infection, heart failure, stroke, or failing to take thyroid medications. A patient will feel extremely weak and lose consciousness. Anyone with hypothyroidism who undergoes a dramatic change in their mental condition or swelling of the feet and hands should go straight to the ER for medical care. Here are more conditions often caused by thyroid disease.
Hashimoto's disease and Graves' disease can trigger thyroiditis
The American Thyroid Association (ATA) defines thyroiditis as an inflamed or swollen thyroid. While Hashimoto's disease is one of the leading causes, there are other factors that can trigger the issue. Thyroiditis can kick in after giving birth (postpartum thyroiditis) or after contracting a virus (known as subacute thyroiditis). Some medications can also cause thyroiditis, particularly ones with higher iodine content.
Thyroiditis can lead to goiter
Hashimoto's disease, Graves' disease, and thyroid nodules—growths that are either tissue-filled or fluid-filled cysts and typically not noticeable until they became large—can lead to a permanently enlarged thyroid gland called a goiter, reports the ATA. Besides the noticeable swelling, goiter symptoms include coughing, hoarseness, trouble breathing or swallowing, and a tight feeling in the throat. A goiter will usually require a similar treatment plan to hyperthyroidism or hypothyroidism, depending on the patient's health history.
Watch for thyroid cancer
In 2018, there were an estimated 53,990 new cases of thyroid cancer, according to the National Cancer Institute (NCI); about 1.2 percent of men and women will be diagnosed with thyroid cancer in their lifetime. Thankfully the survival rate is high, reports the NCI, with a 98 percent five-year survival rate recorded. A goiter or nodules on your thyroid can indicate cancer. Be sure to discuss the possibility of cancer with your doctor should you experience any issues with your thyroid. And read up on the thyroid cancer symptoms you should never ignore.
A simple test can help determine your thyroid health
"The best single screen to determine if your thyroid is underactive or overactive is a thyroid-stimulating hormone (TSH) blood test," says Dr. Narla. "If you are hypothyroid, the TSH will be high; if you are hyperthyroid, the TSH will be low. If your TSH level is normal, it is unlikely that your symptoms would be related to the thyroid, and your doctor can do an evaluation to look for other causes." Make sure you know the 10 hidden dangers of a supposedly "normal" thyroid.
- Archana Durga Narla, MD, an endocrinologist at Crystal Run Healthcare in West Nyack, New York
- American Thyroid Association: "What you need to know about the thyroid!"
- National Institutes of Health: "Hyperthyroidism (Overactive Thyroid)"
- Erik Polan, DO, assistant professor at Philadelphia College of Osteopathic Medicine
- National Cancer Institute: "Cancer Stat Facts: Thyroid Cancer"