Your Thyroid Gland and You

Problems with energy, mental capacity, and weight may be due to thyroid disease. Simple tests can determine if thyroid function is to blame for your symptoms so you can get the treatment you need.

The thyroid is a small, yet powerful gland in the neck that releases hormones that help regulate many of the body’s functions. One of those hormones is thyroxine, which is necessary for the heart, brain, and other organ systems to function properly.

Hypothyroidism vs. Hyperthyroidism: What’s the Difference?
Hypothyroidism and hyperthyroidism have opposite effects on your body. Under normal circumstances, the pituitary gland in the brain tells the thyroid how much hormone it should release. But sometimes infections, medications, and even the body’s own immune system can interrupt communication between the pituitary and the thyroid. When this happens, thyroid function becomes altered – With hypothyroidism, or underactive thyroid, the thyroid gland doesn’t make enough thyroid hormone for the body’s needs; with hyperthyroidism, or overactive thyroid, the thyroid makes too much.

Thyroid Disease: Blood Tests
Fortunately, a simple blood test can provide important information about several hormones related to thyroid function, including:
TSH. Thyroid-stimulating hormone (TSH) is what the pituitary gland releases to tell the thyroid when to produce thyroid hormones. A low level of TSH in the blood usually means that thyroid function is excessive (hyperthyroidism), while a high level of TSH generally indicates that too little thyroid hormone is being produced (hypothyroidism).

T4 (thyroxine). An excess of T4 in the blood is indicative of an overactive thyroid, whereas low levels of T4 indicate underactive thyroid function. Testing T4 blood levels also helps doctors pinpoint whether or not thyroid disease is due to a problem in the pituitary gland or the thyroid gland itself.

T3 (triiodothyronine). T3 is another important thyroid hormone. T3 levels can fluctuate quite a bit, but high levels of T3 are typically due to hyperthyroidism, while low levels are caused by hypothyroidism.
Thyroid antibody. Autoimmune thyroid diseases (like Hashimoto’s thyroiditis or Graves’ disease) cause the immune system to release proteins called antibodies that attack the thyroid as if it were foreign tissue. Blood tests can reveal the presence of thyroid antibodies and allow doctors to diagnose such an autoimmune disease.

The First Steps to Diagnosis
If your doctor suspects that you have thyroid disease, he or she will order blood tests. The blood draw takes just a few minutes. Your doctor will probably schedule another visit or a phone call to discuss these results with you and give you the opportunity to ask any questions.
Diagnosing thyroid disease, determining the cause, and starting treatment can help prevent serious health complications like heart disease and mental health problems. Thyroid tests are easily done and relatively painless, usually only requiring a blood sample or imaging test. Once properly diagnosed, thyroid disease symptoms can generally be managed effectively.
Are You at Risk for Thyroid Disease?
Some people are more likely than others to develop thyroid problems, and although you can’t prevent thyroid disease, it’s important to detect it early.
Risk factors for hyperthyroidism include:
• Being female
• Being over age 60
• Recent pregnancy
• Having an autoimmune disease (such as type 1 diabetes)
• Family history of thyroid disease or autoimmune disease
• Personal history of thyroid problems, like goiter (an abnormally large thyroid gland) or having had thyroid surgery
• Consuming significant amounts of iodine through food or medication

Risk factors for hypothyroidism include:
• Being female
• Being older than age 60
• Exposure to radiation in the neck
• Prior thyroid surgery
• Having a family history of thyroid disease
• Having a family history of autoimmune disease
• Having an autoimmune disease
• Being of Caucasian or Asian ethnicity
• Experiencing hormonal changes due to pregnancy, childbirth, or menopause
• Personal history of lithium use (often prescribed for bipolar disorder)
• Having chromosomal abnormalities like Down syndrome or Turner’s syndrome.

Thyroid Surgery: is it Necessary?
Thyroid surgery isn’t usually the first option when it comes to treating a thyroid condition. Doctors will often try to treat a thyroid problem with medication first, but sometimes they don’t work to manage symptoms as effectively.
Thyroid surgery is most often recommended as a treatment for patients with:
• Hyperthyroidism. This is when the thyroid gland produces too much thyroid hormone due to infection, an autoimmune condition such as Graves’ disease, certain medications, or benign growths on the thyroid or pituitary glands.
• Severe swelling of the thyroid gland. Also called goiter, this can be caused by an iodine deficiency, hyperthyroidism, and certain medications, like lithium. Thyroid gland swelling can become so pronounced that it causes pain and trouble swallowing and eating.

What are the symptoms of Hypothyroidism (underactive thyroid)?
Hypothyroidism signs and symptom may include:
• Fatigue
• Increased sensitivity to cold
• Constipation
• Dry skin
• Unexplained weight gain
• Puffy face
• Hoarseness
• Muscle weakness
• Elevated blood cholesterol level
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Heavier than normal or irregular menstrual periods
• Thinning hair
• Slowed heart rate
• Depression
• Impaired memory

What are the symptoms of Hyperthyroidism (overactive thyroid)?
Hyperthyroidism can mimic other health problems, which may make it difficult for your doctor to diagnose. It can also cause a wide variety of signs and symptoms, including:
• Sudden weight loss, even when your appetite and the amount and type of food you eat remain the same or even increase
• Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute — irregular heartbeat (arrhythmia) or pounding of your heart (palpitations)
• Increased appetite
• Nervousness, anxiety and irritability
• Tremor — usually a fine trembling in your hands and fingers
• Sweating
• Changes in menstrual patterns
• Increased sensitivity to heat
• Changes in bowel patterns, especially more frequent bowel movements
• An enlarged thyroid gland (goiter), which may appear as a swelling at the base of your neck
• Fatigue, muscle weakness
• Difficulty sleeping
• Skin thinning
• Fine, brittle hair

Being aware of your level of risk for thyroid disease, and telling your doctor about any symptoms, can allow for early diagnosis of thyroid problems. Early detection is key because it can prevent the development of additional health problems. If you have a family history of thyroid disease and notice possible thyroid disease symptoms, don’t hesitate to talk to your doctor.
Dr. Van Epps is an independent concierge physician in Northern Nevada.