You probably don’t give your thyroid much thought. This quarter-sized gland just below your Adam’s apple secretes hormones that moderate your metabolism, heart rate, mood -- and more. It works quietly in the background, until something goes wrong.
One in 10 people worldwide have thyroid disease, and it affects women more often than men. The most common cause is Hashimoto’s thyroiditis, an autoimmune disorder. Grave’s disease can also affect the thyroid, as can side effects of medications, excess or inadequate iodine or other problems with your thyroid gland.
Fatigue and hair thinning are the most common symptoms of thyroid disease I see in my practice, but there are others. In fact, the symptoms are nearly opposite for an underactive versus an overactive thyroid. Both hyperthyroidism and hypothyroidism can present with an enlarged thyroid.
Symptoms of an Underactive Thyroid (Hypothyroidism)
- You may feel tired, forgetful and have sensitivity to cold. You may gain weight and have heavy or frequent menstrual periods. Your hair may thin and become dry and your voice can become hoarse.
Symptoms of an Overactive Thyroid (Hyperthyroidism)
- You may feel anxious, irritable, nervous and have sensitivity to heat. You may have trouble sleeping and experience weight loss, muscle weakness/tremors and have irregular or stopped menstrual periods.
How is Thyroid Disease Diagnosed?
Diagnosing thyroid disease generally takes a simple blood test to check your hormone levels for an underactive or overactive thyroid.
- TSH Test - This initial test checks for the amount of TSH hormone in your blood. If it is high, it’s usually an indicator you may have hypothyroidism. If it is low, it’s usually an indicator you may have hyperthyroidism.
- Free T4 Test - Depending on the TSH test, your doctor may get a free T4 test which is used to confirm the diagnosis of hypothyroidism.
- Other Tests - You may have further blood testing (such as thyroid antibodies for hyperthyroidism) or imaging done (thyroid ultrasound) to determine the cause of thyroid disease.
Thyroid Disease Treatments
Treatments for hypothyroidism are effective and individualized to you. For hypothyroidism, we typically start a dose of a thyroid medication to see if it helps with symptoms. If you are older, we may start with a lower dose. This decision is based on symptoms. We want to make sure you are feeling better on the medication, so we will have you come back after six weeks to get repeat TSH and T4 levels -- and adjust your medication up or down accordingly.
Treatment for hyperthyroidism is more varied and includes beta blockers to lower heart rate, medications to reduce thyroid hormone levels, radioiodine injection to slow down thyroid production or surgical removal of part of the thyroid.
Diagnosing and treating thyroid disease is important because untreated thyroid problems can lead to other conditions, including heart problems, obesity, joint pain and infertility. If you have symptoms or questions, contact your primary care provider.