For such a little gland, it can cause some big problems. The thyroid is a small gland in the neck that secretes hormones needed to regulate metabolism. Everything from body temperature to weight to energy are metabolically modulated, so an imbalance in thyroid function can cause a range of unpleasant symptoms.
Too much thyroid hormone (hyperthyroidism) can cause weight loss, rapid heartbeat, anxiety, insomnia, sweating and muscle weakness. Not enough thyroid hormone (hypothyroidism) can cause the opposite: weight gain, fatigue, hair loss, sensitivity to cold, joint or muscle pain, and depression.
However, thyroid disorders are relatively easy to diagnose and treat. “Usually, the first test to order is a TSH (thyroid stimulating hormone), which is a good screening test,” says Dr. Deepashree Gupta, a SLUCare endocrinologist. If TSH levels are abnormal, physicians may order a more comprehensive blood test that measures levels of specific thyroid hormones. Based on these findings, physicians can initiate treatment.
“Thyroid disorders are relatively easy to treat,” Gupta says. “People are started on thyroid hormone supplementation in hypothyroidism, and anti-thyroid medications in the setting of hyperthyroidism. Labs need to be monitored routinely if patients are on these medications. If medications don't help, the other options for treatment of hyperthyroidism are radioactive iodine ablation or thyroid removal surgery. The latter can be associated with cure in hyperthyroidism.”
Hypothyroidism is the most common scenario, and it is often associated with an autoimmune disorder known as Hashimoto’s thyroiditis. The disease is much more common in women than men, and tends to be diagnosed between the ages of 40 and 60. For some people, the diagnosis explains years of symptoms often chalked up to behavioral or dietary causes. Treatment can provide relief and improve quality of life.
However, not every weight gain, fatigue, hair loss, etc., means thyroid disease, notes Dr. Veronica McGregor, a Mercy Clinic endocrinologist. “Consider if you are sleeping at least seven hours a night, if you are exercising regularly, and if you are eating healthy foods and normal portions.”
Because the thyroid needs the mineral iodine for hormonal production, iodine deficiency has been related to thyroid disorders. But this is much more common in developing nations where malnutrition is more widespread. Iodine fortifies many foods in the typical American diet, particularly iodized table salt.
Gupta advises patients who have a family history of thyroid disorders to have their TSH levels checked annually. Twenty million Americans may have thyroid disease, and as much as 60 percent are undiagnosed, according to the American Thyroid Association.