Thyroid disorders are very common in the United States, affecting an estimated 20 million people. Women are five to eight times more likely to be diagnosed than men, but thyroid disorders affect all genders. Despite how common thyroid disorders can be, problems with this tiny gland can be hard to recognize without the help of a physician.
What is the Thyroid?
The thyroid is a small gland located in the front of your neck, just under the skin below the Adam’s apple. Despite its size, it plays a big role in regulating your entire body by controlling how you use energy. It does this by producing hormones that control metabolism, growth and development – influencing vital functions like heart rate, digestion, body temperature and more.
In turn, the thyroid’s hormone production is balanced by the pituitary gland, a small pea-sized gland located at the base of your brain. The pituitary gland is often called the “master gland” because it controls almost all of the body’s other hormone-secreting glands.
Thyroid disorders are a group of conditions affecting the balanced function and hormone production of the thyroid gland. Some of the different thyroid disorders include hypothyroidism, hyperthyroidism, thyroid cancer, goiter, thyroid nodules and thyroiditis. Hypothyroidism and hyperthyroidism are the most common disorders and can usually be diagnosed by blood and imaging tests. In either case, the health implications can be serious, especially if left untreated.
Hypothyroidism (Underactive Thyroid)
When the thyroid gland is underactive, it is called hypothyroidism. With hypothyroidism, the thyroid produces insufficient hormones, leading to fatigue and weight gain.
Often, hypothyroidism is caused by an underlying autoimmune disorder called Hashimoto’s disease. With Hashimoto’s disease, the body’s immune system creates antibodies that attack the thyroid gland, leading to hypothyroidism (underactivity). Hashimoto’s disease is the most common cause of hypothyroidism in the US.
Signs and Symptoms of Hypothyroidism:
- Fatigue
- Unexplained weight gain
- Sensitivity to cold
- Dry skin
- Thinning hair
- Depression
If left untreated, hypothyroidism can also lead to high cholesterol.
Hyperthyroidism (Overactive Thyroid)
When the thyroid gland is overactive, it is called hyperthyroidism. In this case, the thyroid gland produces excessive hormones, causing increased heart rate, weight loss and anxiety.
Sometimes the underlying disorder causing hyperthyroidism is Graves’ disease. With Graves’ disease, the body creates antibodies, called thyroid-stimulating immunoglobulins, that cause the thyroid gland to produce too much hormone, leading to hyperthyroidism (overactivity).
Signs and Symptoms of Hyperthyroidism:
- Rapid heartbeat
- Unexplained weight loss
- Excessive sweating
- Anxiety
Individuals suffering from either disorder may notice changes in their hair and nails, feelings of muscle weakness or swelling in the neck (goiter).
Thyroid Disorders and Women
Women are much more likely to develop thyroid disorders than men, although the research is not clear as to why. An estimated one in eight women will face thyroid problems during their life. Thyroid disorders can cause menstrual problems, difficulty getting pregnant and issues during pregnancy. Women with thyroid disorders who are trying to get pregnant should talk to their healthcare provider.
There is some evidence to suggest a link between polycystic ovary syndrome (PCOS) and hypothyroidism. The link between these two diseases is not well understood, but it is important to screen for hypothyroidism if you have PCOS.*
*Reference: Association between PCOS and autoimmune thyroid disease: a systematic review and meta-analysis Mírian Romitti,1,* Vitor C Fabris,2,* Patricia K Ziegelmann,3 Ana Luiza Maia,1 and Poli Mara Spritzer2
Thyroid and Pregnancy
Thyroid disorders can affect pregnancy in many ways. Thyroid hormones are very important in the development of a baby’s brain and nervous system.
During pregnancy, estrogen surges, which increases the amount of thyroid hormone needed in the body. However, in patients with hypothyroidism, the thyroid gland may not be able to create enough hormone to meet the demand, which raises the risk for first-trimester miscarriages, low birth weight, threatened preterm labor and other fetal complications.
Hyperthyroidism in pregnancy is usually caused by Graves’ disease. Graves’ disease may first appear during pregnancy. Untreated hyperthyroidism during pregnancy can lead to miscarriage, premature birth, preeclampsia, low birthweight and congestive heart failure.
While not common, some women can develop postpartum thyroiditis, which is swelling of the thyroid gland. This disease commonly has three phases. First, patients exhibit an overactive thyroid that could last for several months, which is followed by a period of recovery, but can ultimately lead to a permanently underactive thyroid gland, or hypothyroidism.
Interestingly, in some patients, symptoms of thyroid disease may temporarily disappear during pregnancy as pregnancy can create a state of “immune suppression”. However, there is often a rebound of symptoms after the pregnancy.
Treatment for Thyroid Disorders
Treatment for thyroid disorders will vary depending on a patient’s specific condition and needs. Hypothyroidism is usually managed with synthetic thyroid hormone replacement medication to restore balanced hormone levels. Hyperthyroidism may be treated with medications (like antithyroid drugs), radioactive iodine therapy (to destroy the overactive thyroid cells) or surgery to reduce hormone production.
If thyroid nodules (lumps on the gland) are found, you would most likely have a biopsy completed. If the nodules were cancerous, your doctor may order radiation therapy or surgery.
If you think you may be experiencing symptoms of a thyroid disorder, schedule an appointment with your healthcare provider to discuss. They can assess your situation and refer you to a specialist, like an endocrinologist, for diagnosis and treatment.
To learn more about TMH’s thyroid and other endocrinology services, visit TMH.ORG/EOD.
