Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Nov 14, 2018
Last Modified Date: Nov 14, 2018
Published Date: Nov 14, 2018
- What Is the Thyroid and How Does It Function?
- What Is Hypothyroidism?
- Alphabetical List of Hypothyroid Symptoms
- What Is Hyperthyroidism?
- Alphabetical List of Hyperthyroid Symptoms
- Understanding Thyroid Effects on Your Health
- When and Why You Might Need a Thyroid Function Blood Test
- Treatment for Hypothyroidism
- Treatment for Hyperthyroidism
- Could Thyroid Medication Cause Insomnia and Dangerous Weight Loss?
- Maintaining Healthy Thyroid Hormone Levels
- Preventing Thyroid Problems in Women
- Preventing Thyroid Problems in Men
- Common Questions About Thyroid Disease
Thyroid problems are very common, affecting more than 12 percent of people during their lifetimes, according to the American Thyroid Association. Left undiagnosed and untreated, thyroid disease can have serious health effects, increasing the risk of cardiovascular disease, osteoporosis and obesity. Unfortunately, since thyroid problem symptoms can be quite similar to those of many other common conditions, up to 60 percent of the estimated 20 million Americans who have thyroid problems are not aware of it.
Essential to our existence, the thyroid hormone affects nearly every cell in the body, serving as a type of “speed control” and thermostat. Virtually all metabolic processes are affected by the thyroid. The hormone gland, shaped similar to a butterfly, has a right and a left lobe “wing.” These wings wrap backward around the trachea and are attached to the upper front of the trachea and the lower part of the larynx, or voice box.
When things go wrong with the thyroid, it can lead to a host of systemic problems including weight gain or rapid weight loss, depression, anxiety, fatigue and even heart disease. Too much of the hormone can result in hyperthyroidism, also known as thyrotoxicosis, while too little can cause hypothyroidism. Nearly 60 million people in the U.S. suffer from some type of thyroid disorder. Many are not even aware they have a problem. Both sexes are affected, but hypothyroidism tends to be more common in women.
Blood tests that measure thyroid level hormones can help determine if the thyroid is functioning properly. The most sensitive blood test to assess thyroid hormone status is the Thyroid Stimulating Hormone (TSH) test. TSH is produced by the pituitary gland. If you have several of the following 10 symptoms, consider having your thyroid levels tested and then discuss the results with your healthcare provider.
What Is the Thyroid and How Does It Function?
Your thyroid is a gland located at the base of the neck. Shaped like a butterfly, it has lobes on either side of your windpipe. Most people also have an isthmus connecting these lobes in the middle. However, some individuals do not have this isthmus and instead have two distinct thyroid lobes that are separate from one another.
You shouldn't be able to feel your thyroid gland if it's healthy. It's only about two inches long. The thyroid's primary purpose is secreting thyroid hormones that help regulate critical body functions. As part of the endocrine system, your thyroid releases these hormones into your bloodstream where they will then travel to the appropriate cells in the body.
The thyroid gland is one of the most important organs of the body's endocrine system in terms of overall health and wellness. The endocrine system is a network of glands throughout the body that produce and secrete hormones. Hormones are powerful chemical messengers that play vital roles in most every vital organ, function and system of the body. Thyroid hormones regulate metabolism, which is the way that the body processes and utilizes energy, making them essential to the function of virtually every cell in the body.
The primary hormones released by the thyroid are T3 (triiodothyronine) and T4 (thyroxine). The hypothalamus and pituitary glands in the brain are responsible for managing these hormone levels. The hypothalamus produces TSH-releasing hormone which indicates whether the body needs more or less of certain thyroid hormones. The pituitary gland receives this information and produces TSH (thyroid-stimulating hormone) which then signals the thyroid gland to increase or decrease levels of T3 and T4 appropriately. When these hormones become unbalanced, as occurs with thyroid disease or dysfunction, metabolic rates are affected. This creates a situation that can produce an array of physical, emotional and cognitive symptoms, and if left untreated, can lead to serious long-term health problems. Fortunately, thyroid problems can be detected with thyroid function testing, and in most cases, treated successfully, alleviating thyroid symptoms and reducing health risks.
The thyroid hormones are responsible for helping your body regulate:
- Heart rate
- Body temperature
- Cholesterol levels
- Muscle strength
When thyroid levels aren't properly maintained, the body can suffer in a wide variety of ways. Patients may experience either hypothyroidism or hyperthyroidism — depending on whether the body is producing too much of the thyroid hormones or too little. The symptoms associated with these conditions are very different, making it difficult for some people to trace their problems back to the thyroid gland. Understanding what to look for will help you recognize key indicators that your thyroid isn't operating as it should.
Types Of Thyroid Disorders
The thyroid gland has the primary function of producing, storing and secreting hormones, called thyroxine (T4) and triiodothyronine (T3), that control the body's metabolism, which is the rate at which every cell in the body uses energy. Since thyroid hormones aid in the control of growth and metabolism, too much or too little of these hormones can cause a wide range of symptoms throughout the body, and if left untreated, can have serious, long-term health effects. Thyroid hormone imbalance can stem from a number of underlying causes, each of which can be, in most cases, treated successfully once a definitive diagnosis of has been established through thyroid function testing.
Two major categories of thyroid dysfunctions exist, which are:
- Hypothyroidism, or underactive thyroid, which causes a deficiency of thyroid hormones in the system, slowing the metabolism.
- Hyperthyroidism, or overactive thyroid, which causes an excess of thyroid hormones in the body, increasing the metabolic rate.
What Is Hypothyroidism?
Hypothyroidism, or under-active thyroid, is a condition in which the thyroid gland fails to produce or secrete sufficient amounts of thyroid hormones, resulting in a sluggish metabolic rate. Underactive thyroid is the most frequently diagnosed form of thyroid dysfunction and can stem from a number of underlying causes. Common causes of deficient thyroid hormone production include auto-immune disorders, in which the immune system attacks the thyroid gland, previous or ongoing hyperthyroid treatment or medications, thyroiditis, or inflammation of the thyroid gland, radiation therapy, iodine deficiency and certain medications. Excessive iodine levels can also cause the thyroid to produce hormones in smaller amounts than it should. Iodine is found in many cold and sinus medicines and a heart medication known as amiodarone. Contrast dyes used during some x-rays also contain iodine. Drugs containing lithium can have a similar effect. Lithium is used to treat mental illnesses, headaches, diabetes, kidney disorders, asthma, and other conditions.
Specifically hypothyroidism results when the body doesn't produce enough T3 and T4 hormones. This is usually associated with a high TSH level because your brain is trying to tell the body that it needs more thyroid hormones. The body, however, is unable to respond due to an underactive thyroid. Hypothyroidism is particularly common in women over the age of 60. Women are at higher risk for hypothyroidism than men. It's more common as you age and has greater prevalence in those who are white or Asian as well as patients with prematurely graying hair. If you have an autoimmune disorder, bipolar disorder, Turner syndrome, or Down syndrome, you're also more likely to develop hypothyroidism.
When the thyroid gland is sluggish, your body also tends to be sluggish. It's not getting the hormones that it needs to signal your body to ramp things up. As a result, you may feel tired and worn down. Left untreated, hypothyroidism can lead to more serious issues like heart disease or infertility. If hypothyroidism becomes advanced, you may experience myxedema. This is a life-threatening condition in which your body temperature and blood pressure become dangerously low. You may even slip into a coma.
You may experience hypothyroidism for a number of reasons. One common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis. With this condition, your body's own immune system produces antibodies that attack the thyroid gland. As a result, the thyroid gland becomes inflamed and the cells may become damaged. Hashimoto's thyroiditis, causes chronic inflammation in the thyroid gland, often reducing its production of thyroid hormones.
Thyroiditis refers to a group of thyroid disorders that cause inflammation of the thyroid gland. Other types of thyroiditis include:
- Postpartum thyroiditis, an inflammation of the thyroid gland that occurs in five to nine percent of women after giving birth, typically a temporary condition.
- Lymphocytic thyroiditis, which is inflammation in the thyroid caused by a particular type of white blood cell known as a lymphocyte, also known as silent thyroiditis.
You may also suffer from hypothyroidism if part of the thyroid is removed to treat other conditions, such as thyroid cancer. In some cases, treatments for hyperthyroidism overcompensate and leave the patient with an underactive thyroid instead. Fortunately, there are many treatment options for hypothyroidism, making this condition very easy to treat. The most important thing is getting the right tests and a clear diagnosis as early as possible.
Hypothyroidism can be tricky to diagnose because the symptoms so often seem to mimic a different type of problem. You might first attribute signs of hypothyroidism to mental illness, particularly depression. However, treating for depression won't resolve all the issues associated with low thyroid hormones. If you're experiencing any symptoms of hypothyroidism, it's important to speak with your doctor. Testing your TSH, T3, and T4 levels can lead to a simple diagnosis.
General Signs You May Have Hypothyroidism
Since thyroid hormones regulate metabolism, the excessive amounts of them that occur with hyperthyroidism increases the metabolic rate. This speeds up virtually all bodily processes, which can cause a wide range of physical, emotional and cognitive symptoms.
Emotional and cognitive symptoms often reported include nervousness, anxiety, irritability, insomnia and difficulties with memory and concentration. Depending upon the cause and severity of hyperthyroidism, signs may build gradually, the most common scenario, or can appear abruptly. These signs include:
Slow pulse rate - an unusually slow pulse rate is between 45 – 60 beats per minute. High blood pressure may accompany the slow rate.
You're Always Exhausted – If you're getting plenty of sleep, but feel exhausted most of the time anyway, you should know that chronic fatigue ranks among the most common symptoms of thyroid problems. Most often, fatigue is caused by hypothyroidism – an under-active thyroid gland, but individuals with hyperthyroidism – or an over-active thyroid gland may develop chronic fatigue if the condition is undiagnosed and untreated for an extended period of time.
Frequent Mood Swings, Irritability and/or Depression – Both hyperthyroidism and hypothyroidism can affect your mood, since both conditions can alter levels of mood-regulating chemicals in the brain.
You Feel Jittery or Anxious – This is a common symptom of hyperthyroidism, as excess thyroid hormones flood the system, kicking a person's metabolism into overdrive.
Unexplained Weight Changes – An under-active thyroid causes the body's metabolism to slow, often prompting unexplained weight gain. Rapid weight loss despite a healthy appetite is a common sign of an over-active thyroid.
You're Forgetful, Can't Concentrate or Have “Brain Fog” – Thyroid problems can affect cognitive function, with poor concentration a common symptom of over-active thyroid and forgetfulness common with under-active thyroid. Both can cause a general feeling of mental slowness or “brain fog.”
Vision Changes or Eye Irritation – Vision and eye changes can occur with Grave's disease, an autoimmune form of hyperthyroidism.
Heart Palpitations, Blood Pressure Problems – Thyroid problems can affect cardiovascular function. Abnormally high levels of thyroid hormones that occur with hyperthyroidism can cause a rapid heartbeat or heart palpitations, making the heart feel as if it's fluttering or has skipped a beat. Both hyperthyroidism and hypothyroidism can increase blood pressure.
Dry Skin, Hair, and/or Nails – Dry, flaky skin is common with low levels of thyroid hormone. Often, people with under-active thyroid will notice their hair thinning or becoming very dry and brittle. Nails may also become dry and brittle and can develop ridges in response to low levels of thyroid hormones.
Bowel Changes – Constipation is a common complaint in individuals with under-active thyroid, since deficient levels of thyroid hormones slow digestion. Hyperthyroidism, on the other hand, can cause frequent bowel movements and/or diarrhea.
Intolerance to cold - caused by the slowing of the metabolic rate.
Depression and psychiatric misdiagnosis - hypothyroidism is linked to depression more often than hyperthyroidism and can be easily misdiagnosed. About 15 percent of all hypothyroid patients are found to be suffering from depression.
Weight gain and digestive changes – with a slowed metabolism, you may experience bloating, poor appetite and heartburn, but still gain weight.
Sleepiness and fatigue – many patients suffering from hypothyroidism report a distinct sluggishness, even after a good night’s sleep.
Other symptoms of hypothyroidism can include high cholesterol, changes in menstrual cycles, muscle problems, a sensation of “pins and needles” in the hands and changes in the voice, in which the voice sounds husky or hoarse.
Too much of the thyroid hormone can result in hyperthyroidism, more commonly known as thyrotoxicosis. The most common form of hyperthyroidism is called Graves’ disease.
Alphabetical List of Hypothyroid Symptoms
- Aches, pains, and tenderness in the muscles or joints
- Carpal tunnel syndrome
- Decreased libido
- Difficulty losing weight
- Difficulty sleeping
- Difficulty with memory
- Dry hair
- Dry skin
- Enlarged or swollen thyroid gland
- High cholesterol
- Increased sensitivity to cold, or seemingly feeling cold for no reason
- Irregular or heavier menstrual periods
- Memory loss
- Muscle weakness or stiffness
- Persistent fatigue
- Puffy face
- Sensitivity to the cold
- Slower heart rate
- Stiff, swollen, and painful joints
- Thinning hair
- Trouble concentrating
- Unexplained weight gain
It's easy to confuse hypothyroidism with something else, particularly since some of the symptoms seem to contradict one another. For example, some patients with hypothyroidism have trouble getting a good night's sleep. Yet, this doesn't mean that they feel jittery and awake. In fact, fatigue and sleepiness are also key symptoms of hypothyroidism. Half of the people with hypothyroidism report feeling constantly tired, and 42 percent say that they sleep more than they used to.
Dry skin is a common symptom that's reported by nearly three-quarters of patients with hypothyroidism. However, dry skin from other causes is present in roughly half of people with normal thyroid levels, so you may not think to associate the two.
Weight gain is another tricky symptom you may not immediately associate with hypothyroidism. Without the proper thyroid hormones, your body gets the signal to hold on to calories in the liver, muscles, and fat tissue. Metabolism slows as well, so you're not burning the calories that you consume as efficiently. One study found that within a year of their initial diagnosis, patients with hypothyroidism gained between 15 and 30 pounds on average.
If you're experiencing any of the signs of hypothyroidism, it's a good idea to talk to your doctor about potentially testing for this condition. Most of these symptoms are easily reversed with proper treatment.
What Is Hyperthyroidism?
Hyperthyroidism is the result of an overactive thyroid, producing excessive amounts of thyroid hormones, accelerating the metabolic rate. This is what happens when the body slows production of TSH but the thyroid continues to produce hormones. As a result, many of your body functions will go into overdrive, working harder than they should. Hyperthyroidism is most likely to occur in women. Your risk is higher if you've been pregnant in the last six months or if you're over the age of 60.
Hyperthyroidism floods your body with an overdose of hormones, so you'll experience symptoms that indicate certain body systems are working more and harder than they should. This may first exhibit as a surge of energy. Hyperthyroidism speeds up your metabolism which will give you an initial boost. However, over time that increased metabolism will simply break down your body since it can't keep up. Over the long term, this will leave you feeling tired and worn down.
The most common cause of hyperthyroidism, according to the American Thyroid Association, is a condition called Graves' Disease. An auto-immune disease that tends to run in families, Graves' Disease occurs when a person's immune system attacks the thyroid gland, stimulating overproduction of hormones. These antibodies may also affect thyroid receptors behind the eyes, resulting in eye changes, described above, that characterize Graves' ophthalmopathy, a complication that leads to permanent eye problems in approximately five percent of patients. While the cause of this disease is unclear, it is known to run in families, and although it can occur in males and females of any age, most often affects young women.
Another cause of overactive thyroid is the growth of nodules on the thyroid gland. Thyroid nodules are common, occurring in 15 to 30 percent of adults, according to Columbia University Medical Center. A small percentage of these growths are functional, meaning that they produce thyroid hormones and can result in hyperthyroidism. Risk of developing thyroid nodules increases with age, and the condition affects women more often than men.
Thyroiditis is inflammation of the thyroid gland, a condition that can cause excessive hormone secretion, leading to symptoms of hypothyroidism. It can be caused by an immune system problem, a viral infection or taking too much thyroid medication. Other causes thyroiditis include excessive iodine intake, often due to overuse of iodine supplements or taking iodine containing medications, and thyroiditis sometimes occurs in women following pregnancy. In most cases, thyroiditis is temporary, with overactive thyroid symptoms lasting up to three months. However, thyroiditis may become a chronic condition in up to five percent of adults.
A condition known as Graves' ophthalmopathy sometimes accompanies hyperthyroidism. Symptoms include red, swollen eyes or protruding eyeballs. You might experience sensitivity to light, blurry vision, and discomfort or tearing in one or both eyes. If you have trouble moving your eyes, experience double vision, or have any inflammation of the eyes, you may have this condition. Your risk for Graves' ophthalmopathy is higher if you smoke.
Hyperthyroidism is the opposite of hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces more thyroid hormones than you need. Also known as an overactive thyroid, this condition tends to put things into overdrive. Roughly 1.2 percent of the population in the United States has hyperthyroidism. Women are more likely to experience hyperthyroidism than men.
Hyperthyroidism is often misdiagnosed and associated with other conditions, such as menopause in women. In middle-aged women, symptoms such as changes to the hair, mood swings, an inconsistent menstrual cycle, and sensitivity to heat are easily attributed to menopause. This is because both hyperthyroidism and menopause affect your hormone levels. Speak to your doctor about your symptoms to get more information about whether they're typical of menopause or may be the result of a thyroid problem. Your physician may also miss a hyperthyroidism diagnosis due to other medications you're taking. If you use beta blockers, these will cover up some signs of hyperthyroidism, making it more difficult for your doctor to put the pieces together and get to the bottom of your issues.
Hyperthyroidism is more likely if you have certain health conditions including type 1 diabetes, pernicious anemia, or primary adrenal insufficiency. You have a greater chance of suffering from hyperthyroidism if you're over the age of 60. Your chances also increase if you've been pregnant within the last six months.
Minor cases of hyperthyroidism in pregnancy typically aren't a cause for concern. However, if you suffer from severe hyperthyroidism while you're pregnant, it's important to treat the condition as it can lead to miscarriage, premature birth, low birth weight, preeclampsia, and congestive heart failure. Understanding the symptoms of hyperthyroidism will help you recognize the condition as early as possible.
General Signs You May Have Hyperthyroidism
Adrenaline Rush – a “fight or flight” hormone, adrenaline is released when you are frightened or highly excited. High levels of the thyroid hormone can cause the heart to speed up and trick the body into thinking it is in “fight or flight” mode. If you are hyperactive and feel warm or hot much of the time, your thyroid may be the cause.
Emotional Changes – irritability, anxiety, sleeplessness, restlessness and even mania have been reported among patients with hyperthyroidism. Family members may note changes in your behavior.
Easy Bruising – platelet disorders are more common in people with hyperthyroidism, which can cause bruising as tiny capillaries become more fragile and burst.
Enlarged Thyroid Gland or Goiter – a goiter is an enlarged thyroid gland that swells in front of the neck and can vary in size from a walnut to the size and shape that resembles a grapefruit. A goiter may or may not accompany hyperthyroidism.
Heart Palpitations – a rapid, forceful heartbeat that can serve as one of the first signs of thyrotoxicosis. It is caused by increased levels of thyroxine released from the thyroid gland, which stimulates the heart to beat faster and stronger. When you are conscious of these beats, they are known as palpitations. Untreated palpitations can lead to heart problems that, if associated with thyrotoxicosis, can eventually cause damage to the heart.
A rapid heartbeat counts as anything over 100 beats per minute. While your heart rate will rise when you're exerting yourself (during a workout, for example) you shouldn't maintain this high heart rate when you're relaxed. You may also feel your heart pounding for no reason or beating irregularly.
Other symptoms of hyperthyroidism can include chronic fatigue, changes in vision and lid retraction (the “thyroid stare”), swollen fingertips, changes in hair growth cycles, changes in skin texture, trembling hands and weight loss due to increased metabolic rate. (Older individuals may actually gain weight).
Alphabetical List of Hyperthyroid Symptoms
- Brittle hair
- Changes to the menstrual cycle
- Diarrhea or frequent bowel movements
- Difficulty sleeping
- Enlarged or swollen thyroid gland
- Fine and brittle hair
- Increased appetite
- Mood swings
- More frequent bowel movements
- Muscle weakness
- Nervousness and anxiety
- Rapid or irregular heartbeat
- Sensitivity to heat
- Swelling at the base of the neck (goiter)
- Thinning skin
- Tremors in the hands and fingers
- Trouble sleeping
- Unexplained weight loss
Some of these symptoms are difficult to recognize at first. For example, weight loss may not seem like a problem. However, with hyperthyroidism, you will often notice weight loss accompanied by an increase in appetite. Therefore, you could find that you're eating more than usual but the pounds are falling off. This is a major indicator that something is amiss.
Understanding Thyroid Effects on Your Health
Your thyroid is responsible for producing hormones that control many of your body's essential functions. If there's a problem with your thyroid, you should seek treatment as soon as possible. Leaving thyroid issues untreated can cause long-term complications and serious side effects. Thyroid issues are often difficult to diagnose because the symptoms are so varied. Thyroid problems are often mistaken for other issues.
Hypothyroidism and Hashimoto's Disease
Hypothyroidism is often caused by a condition known as Hashimoto's disease. This causes your immune system to attack the thyroid. The damaged thyroid is then unable to produce the necessary thyroid hormones. This disease is alternately known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. Hashimoto's disease is eight times more common in women than in men. It's typically diagnosed between the ages of 40 and 60.
It's important to seek treatment for Hashimoto's disease. Left untreated, it can lead to a number of complications including increased risk of heart complications, depression, decreased libido, and enlargement of the thyroid gland (known as goiter). Untreated Hashimoto's disease can also lead to myxedema. This condition exhibits as drowsiness which later develops into lethargy followed by unconsciousness known as a myxedema coma. A cold or infection can develop into myxedema in patients who have had long-term untreated hypothyroidism. This condition requires immediate medical treatment.
The Thyroid and Pregnancy
The thyroid gland is one of many body systems that may change during pregnancy. The thyroid plays a critical role in the development of the fetus and in the mother's health. Some problems can have far-reaching effects.
Pregnancy and the Thyroid Gland
The thyroid gland produces hormones that are essential to many vital bodily organs and systems. Thyroid hormones aid in regulating metabolism, helping the body use energy and regulate its temperature, as well as supporting healthy function of the brain, heart and muscles, among other organs.
During pregnancy, important changes occur in the thyroid. To meet the needs of the mother and fetus, the thyroid may enlarge, becoming about 10 to 15 percent larger than normal, and thyroid hormone levels in the bloodstream will increase.
If you are pregnant and have thyroid disease, including hypothyroidism and antibodies for autoimmune thyroid disease, you are at increased risk for miscarriage, premature delivery, postpartum thyroiditis and other conditions.
Hyperthyroidism (Over-Active Thyroid) during Pregnancy
Hyperthyroidism is when too much thyroid hormone is produced. This speeds up many body processes. Untreated hyperthyroidism can cause rapid or irregular heartbeat, oversensitivity to heat, fatigue, nervousness, tremors, insomnia, weight loss, and nausea and vomiting. Untreated hyperthyroidism during pregnancy can escalate into a severe form of hyperthyroidism that is life-threatening.
Hypothyroidism (Under-Active Thyroid) During Pregnancy
Hypothyroidism is when the thyroid gland produces too little thyroid hormone, slowing body processes. Untreated or inadequately treated hypothyroidism can cause problems in pregnant women that include anemia, muscle pain and/or weakness, oversensitivity to cold, constipation, memory and/or concentration problems, congestive heart failure, placental abnormalities. It is associated with serious risks to the mother and fetus.
Thyroid Nodules During Pregnancy
Hyperthyroidism and hypothyroidism are the most common issues you can experience with your thyroid, but you may also experience small lumps known as thyroid nodules. These fluid-filled bumps form in the thyroid and are often discovered by a doctor during a routine physical. Many thyroid nodules cause no symptoms, and only a small percentage are indicative of thyroid cancer.
Thyroid nodules can cause hyperthyroidism, in which case you'll experience the previously mentioned symptoms associated with this condition. Otherwise, the only symptoms of thyroid nodules are swelling at the base of the neck or bumps on the thyroid gland that you can feel. If you press on your windpipe, these nodules may cause difficulty breathing and make it difficult to swallow.
After diagnosing thyroid nodules, your doctor will typically want to keep an eye on them to make sure they don't grow. The nodules can be examined by ultrasound and are typically checked every six to 12 months. Those that increase in size or are otherwise suspicious should be removed to check for cancer. Surgery may be recommended for some benign nodules as well.
Hypothyroidism in Infants and Children
Proper thyroid hormones are critical for the growth and development of infants and children. If young patients don't have enough of the key thyroid hormones, they can suffer from growth failure and intellectual disabilities. Some infants are born with a condition known as congenital hypothyroidism. Routine screenings typically check for this condition in newborns. This can be treated with synthetic thyroid hormones.
About 30 percent of infants with congenital hypothyroidism will go on to develop a normally functioning thyroid. The rest will continue taking replacement hormones throughout their lives.
Acquired hypothyroidism develops later in a child's life. This affects about 1 in 1,250 children. Children can exhibit many of the same symptoms as adults. However, there are additional symptoms to look out for in younger patients. These include:
- Delayed puberty
- Delayed tooth development
- Growth retardation
- Delayed skeletal maturation
If you notice slow growth rates or delayed development of any kind in your child, it's important to speak with your doctor about these symptoms. Diagnosing hypothyroidism early is crucial in infants and children as it can prevent severe long-term problems.
Hyperthyroidism in Infants and Children
Hyperthyroidism is rare in infants, but it may develop in the fetuses of women who have or have had Graves disease. Graves disease is a common cause of hyperthyroidism. With this condition, the body produces antibodies that attack the thyroid receptor, bond to the TSH receptors, and overstimulate the production of thyroid hormones. These antibodies can cross the placenta and cause intrauterine Graves disease. This can lead to premature birth or fetal death.
A fetus with hyperthyroidism will exhibit poor intrauterine growth, goiter, and a high heart rate. This makes it possible to diagnose the condition as early as the second trimester. Infants born with hyperthyroidism can suffer from irritability, hypertension, tachycardia, and feeding problems. The antibodies are cleared after birth, so the infant does not suffer from a lifelong case of Graves disease. The hyperthyroidism typically clears within six months.
In over 90 percent of cases where children and adolescents have hyperthyroidism, it is the result of Graves disease. In some cases, infections can cause a transient case of hyperthyroidism in children. Symptoms of hyperthyroidism in children are much the same as in adults. Parents may notice hyperactivity, trouble concentrating at school, trouble sleeping, and mood swings. As the hyperthyroidism is almost always associated with Graves disease, you may also notice eye-related symptoms, such as red eyes or eyelid lag.
Changes in growth and development may indicate a thyroid problem as well. In some cases, hyperthyroidism will cause growth acceleration and advanced bone age. However, it may also result in delayed puberty, so it's important to discuss any developmental concerns with your doctor for a better assessment of the child's case.
When and Why You Might Need a Thyroid Function Blood Test
How Is Thyroid Disease Diagnosed?
Thyroid disease is relatively simple to diagnose with the right blood tests. There are several tests that your healthcare provider may choose to run to evaluate your thyroid function. A TSH test is typically a good place to start. A high TSH level is indicative of hypothyroidism. Low TSH levels indicate an overactive thyroid that's causing hyperthyroidism. If your TSH level is normal, this usually indicates a healthy thyroid. No further testing will be needed in regards to thyroid disease, but you should continue to work with your doctor to identify the cause of any symptoms you've been experiencing.
A T4 test is often run in conjunction with the TSH test to provide additional information on the type of thyroid issue you're facing. A T4 test looks at T4 hormones that are bound to proteins as well as those that are free. It will measure both your free T4 (FT4) levels and your overall free T4 index (FTI).
In most cases, high FT4 and FTI levels indicate hyperthyroidism while low FT4 or FTI levels indicate hypothyroidism. However, there are some important considerations that come into play when this test is combined with the TSH blood test. Though a low THS usually indicates hyperthyroidism, it may also point to hypothyroidism when combined with an elevated FT4 or FTI on the T4 test.
Patients with hyperthyroidism may go on to get a T3 test. This will help determine the severity of the disease. Some patients have a low TSH but normal FT4 and FTI. However, they may exhibit an elevated T3 level. T3 levels are often normal in patients with hypothyroidism, even when the case is severe, so this test is typically reserved only for those with an overactive thyroid glad.
You shouldn't ignore the signs and symptoms that will point you toward a TSH blood test. Getting this one simple test will give you valuable information for protecting your health. Read on to learn about what TSH does and how high and low TSH can impact your body. Understanding when you need to get a TSH blood test is important because diagnosing thyroid issues at the right time can save you from long-term complications.
What Is Thyroid Stimulating Hormone?
The thyroid stimulating hormone, or TSH, is an important part of your endocrine system. This system includes your hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, and more. TSH is one key part of proper functioning within this system. If your TSH levels are either too low or too high, it will clue your doctor in to issues with your thyroid gland that should be addressed.
Thyroid stimulating hormone (TSH) is an important hormone released by the pituitary gland in the brain. This is one of many hormones involved with the thyroid. Thyroid hormone activity begins in the hypothalamus. The hypothalamus sits at the base of the brain, below the thalamus and above the pituitary gland. The hypothalamus produces TSH releasing hormone (TRH). As the name suggests, this hormone tells the pituitary gland to release TSH.
When TSH is released into the bloodstream, it prompts the thyroid gland to release its own hormones. The thyroid gland sits in the neck, around the trachea, and is shaped like a bowtie with a right lobe and left lobe connected by a narrow strip of tissue known as an isthmus in the middle. Some individuals do not have this isthmus and instead have two separate lobes.
If the brain determines that your thyroid levels are too low, it will release more TSH to boost the production of those hormones. If your body has too much of these hormones circulating in the bloodstream, the brain will reduce the amount of TSH that it produces.
There are two primary thyroid hormones that are impacted by the production of TSH — triiodothyronine (T3) and thyroxine (T4). T3 and T4 hormones travel throughout the body in the bloodstream. They're responsible for regulating several critical functions including your heart rate, body temperature, and cholesterol levels.
The thyroid also produces a hormone known as calcitonin. Made by c-cells in the thyroid gland, this hormone is related to your bone metabolism and helps regulate levels of calcium and phosphate. Calcitonin reduces calcium levels in the blood while the parathyroid hormone increases them. The role of calcitonin is relatively minor, and no major side effects have been noted with either low or high levels, so it's the other thyroid hormones that doctors primarily focus on when evaluating your TSH levels and how TSH is working in your body.
How Do Thyroid Hormones Work?
TSH is only one small part of the chain of hormones that are associated with the thyroid. TSH travels to the thyroid, but it is the T3 and T4 hormones that are actually produced by this gland. TSH is important to the overall process because of the messages that it communicates. When TSH reaches the thyroid, it binds to receptors on cells in the thyroid gland. These cells will then either increase or decrease their production of thyroid hormones.
Your body uses iodine to produce thyroid hormones. If it doesn't have enough iodine, it may not produce the proper levels of T3 and T4, despite the messages that it's receiving from the TSH. Your body cannot produce iodine on its own, so it must receive it from other sources. Your thyroid cells are the only ones in the body that can absorb iodine, so they have a monopoly on this commodity.
While iodine deficiency can cause thyroid problems, it's important to recognize that this is rare in the United States. Iodine is present in salt, bread, dietary supplements, and many water sources. The body needs 60 micrograms of iodine daily to produce thyroid hormones. In North America, the average iodine intake is 200 to 700 micrograms a day. Unless you're consuming a severely restrictive diet, you probably won't experience an iodine deficiency. This doesn't mean that you won't develop thyroid problems, only that iodine isn't likely the underlying cause of your issue.
What Do TSH Levels Tell You?
Your TSH level isn't a direct reflection of how much T3 and T4 your body has, because the thyroid gland doesn't necessarily produce as much of these hormones as the body is asking it to. Rather, your TSH levels are one piece of the puzzle that will help your healthcare provider get to the bottom of the issue if your thyroid hormones aren't where they should be.
If you have low thyroid hormones but high TSH, this indicates that the thyroid gland is underactive. Though it's receiving the message to make more T3 and T4, it's unable to do so. This is a condition known as hypothyroidism. When your TSH levels are high but your T3 and T4 levels are low, this indicates that your brain is signaling the thyroid gland to slow down its hormone production, but the gland is not responding properly. This condition is known as hyperthyroidism.
Your healthcare provider will often test your T3 and T4 levels with your TSH hormone. If T3 and T4 levels are not tested with your TSH levels, this test will be the next order of business should your TSH levels come back abnormal. You can't properly diagnose a thyroid problem unless you have information on all of these hormones.
A normal range for your TSH hormone is 0.4 to 4.0mIU/L (milli-international units per liter). If you're being treated for a thyroid disorder, your doctor will want to see these numbers in a smaller range, between 0.5 and 3.0mIU/L.
TSH levels are usually the opposite of your thyroid hormone levels. However, in some cases, you may find a low TSH level along with low T3 and T4 levels. This could be the result of a hypothalamic or pituitary process, severe euthyroid sick syndrome, or other problems. Your physician should examine several different aspects of your thyroid function before making a final diagnosis.
What Indicators Let You Know You Need a TSH Test?
In general, you should take a TSH test any time you're experiencing symptoms associated with hyper- or hypothyroidism. This covers a very broad range of issues. You may have thyroid problems if you're either underweight or overweight. Both constipation and increased bowel movements are associated with various thyroid conditions. Trouble sleeping and irritability are associated with both hyper- and hypothyroidism. A goiter is another strong indicator of a thyroid problem. Your doctor may be able to identify an issue with your thyroid simply by feeling your neck.
For older women, a TSH screening may be a routine part of a general physical exam. Since thyroid problems aren't rare and may impact such a wide range of body systems, it's a good idea to include this in any set of tests if you're trying to diagnose a vague disease with many symptoms.
A TSH screening may also be a good idea for pregnant women. Thyroid changes during pregnancy can cause complications in some cases. Roughly one in 250 women experience hypothyroidism in pregnancy, while one in 500 experience hyperthyroidism. If you have either condition, it should be monitored carefully throughout your pregnancy so you can identify complications and other issues as early as possible.
How Does a TSH Blood Test Work?
A TSH blood test is very similar to other types of blood work that you may have done. There is no particular preparation that you need to go through before having a TSH blood test done. However, you should discuss all medication that you're taking with your doctor. Certain drugs may impact the results of your TSH test, so it's important for your healthcare provider to take these into account when evaluating your results.
Today's highly sensitive TSH tests can be used to diagnose thyroid issues before you're showing severe symptoms. It's possible that a TSH screening will clue you in about pending hypo- or hyperthyroidism even before your T3 and T4 levels have changed significantly.
If you are diagnosed with a thyroid condition, you will likely have many TSH tests done in the future. Your doctor will want to order another such test after a few weeks of treatment to determine its effectiveness. Close monitoring of your TSH, T3, and T4 levels is important so that you can properly manage your condition. The amount of medication that you need can change as your thyroid levels fluctuate. Fortunately, a TSH test is always quick and easy, requiring just a little bloodwork for accurate results.
What Happens After You Get TSH Blood Test Results?
A TSH blood test is only the first step in identifying thyroid issues. As mentioned previously, if you have this test performed alone, you will need to follow up by testing your T3 and T4 thyroid hormones once you get an abnormal result on your TSH screening. You're more likely to have an abnormal TSH with normal T3 and T4 levels than the opposite, which is why TSH is often tested first. Changes to TSH levels can be an early precursor to hyper- or hypothyroidism later on.
Once you've been diagnosed with hyper- or hypothyroidism, your doctor may go on to order further tests to diagnose either Graves' disease in cases of hyperthyroidism or Hashimoto's disease if you have hypothyroidism.
Though it can be frustrating to go through so many rounds of testing, it's important to recognize that these simple blood tests can give you a wealth of information about your health. After completing these tests, your doctor will have the necessary information to help you develop a personalized treatment plan that will restore your thyroid hormones to the proper levels.
Thyroid problems may seem to cause only minor discomforts for some, but both hyper- and hypothyroidism are dangerous when left untreated. With such simple treatment options, there's little reason not to pursue a solid diagnosis and long-term treatment.
Thyroid Testing Accuracy
People who have low levels of thyroid hormone actually have comparatively high levels of TSH, because their brains are attempting to increase hormone levels. This test is relatively reliable, with a sensitivity rating of 90 percent. Nine out of 10 patients can expect their thyroid problems to be identified accurately.
Most of the inaccuracies actually involve people with normal thyroid hormone levels mistakenly being identified as having under-active hormone production. Because of this, doctors often use a free T4 test to confirm the results of a TSH test. This test measures how much thyroid hormone is actually in your blood and helps to rule out a false positive.
Treatment for Hypothyroidism
If you suffer from hypothyroidism, you will need to take a medication to increase your thyroid hormones. Hypothyroidism is typically treated with a synthetic thyroid hormone. This is not a cure for the condition, but it will help you manage the symptoms.
The most common medication for hypothyroidism is levothyroxine. This is a synthetic version of the T4 hormone. Popular options include Levothroid and Synthroid. These are oral medications that you can take once a day to help increase your thyroid levels. It's best to take these pills at the same time every day, to provide your body with steady, ongoing access to the necessary hormones. If you allow your hormone levels to fluctuate, you're likely to feel the impact. Proper dosage is critical when you're taking thyroid medication. You doctor will need to check your thyroid hormone levels with a blood test every six months to make sure you're using the right dose.
Hypothyroid treatments usually begin to take effect within about two weeks. One of the first changes that you'll notice is an increase in your energy levels. If you've gained weight as a result of the hypothyroidism, this excess weight may begin to melt away. Your cholesterol levels should drop and other symptoms will begin to reverse themselves. After about six weeks, your doctor will check your thyroid levels again and adjust your dosage as needed.
Hypothyroidism is typically a lifelong condition. You'll need to stay on your medication indefinitely to supply your body with the proper level of thyroid hormones. Your doctor will check your hormone levels at least once a year and adjust your dosage as necessary. If you notice a recurrence of symptoms, you should contact your doctor to schedule another round of TSH, T3, and T4 testing as soon as possible. This will help you head off any more problems before they become too severe.
Avoid taking iron supplements, calcium supplements, certain antacids, and cholestyramine when you're taking levothyroxine. These interfere with your ability to absorb the medication. If you need these other supplements or medications, talk to your doctor about finding the right balance for your health.
You can also experience symptoms from having too high of a dosage. If your body increases its own output of thyroid hormones but you don't change the dosage of your medication, you'll suddenly have an excess of these hormones where you previously dealt with a deficit. Indicators that your medication dosage is too high include difficulty sleeping, heart palpitations, an increased appetite, and shakiness.
Treatment for Hyperthyroidism
There are many different treatments that you might explore for hyperthyroidism. Antithyroid medications will address the underlying issue beneath your hyperthyroidism. Drugs like methimazole and propylthiouracil can block the thyroid's ability to produce hormones, thus decreasing the amount that's released into the body.
Antithyroid medications will help lower the levels of thyroid hormones in your body, but it may take months before your hormones are back in a healthy range. This is an ongoing treatment option. Patients will typically stay on them for a period of about 18 months to help prevent a relapse of the condition. This treatment does not cure your hyperthyroidism, but rather manages it. You will need to continue visiting your doctor for regular tests to see where your hormone levels are and adjust your dosage as needed.
Patients with hyperthyroidism may also benefit from the use of beta-blockers. Beta blockers will help relieve some of the symptoms of hyperthyroidism quickly. You can begin feeling better within just a few hours of taking beta blockers. These medications impact the way the thyroid hormone acts on your body. Beta-blockers are typically used to treat high blood pressure and can work effectively to help slow your heart rate if you're struggling with this symptom.
Other treatments for hyperthyroidism are more permanent. However, these almost always result in hypothyroidism, which you must then control with medication as mentioned above. Radioiodine therapy is an oral treatment that destroys some of the body's thyroid-producing cells. This medication helps shrink your thyroid gland over a period of three to six months, slowing it down and reducing the amount of thyroid hormones that are being released. The risk of this treatment is that it may overcompensate for your hyperthyroidism, leading to hypothyroidism. In this case, you will need to start taking replacement hormones for your thyroid.
In extreme cases, your doctor may recommend surgery to remove some or all of the thyroid gland. Though this will eliminate the symptoms of hyperthyroidism, it eliminates your body's ability to produce thyroid hormones entirely. Patients who undergo this procedure, known as a thyroidectomy, must take thyroid hormone medications for the rest of their lives.
In nearly any situation, you will require ongoing testing once you've been diagnosed with hyperthyroidism. You may struggle to maintain proper thyroid hormone levels throughout your life. By monitoring your TSH, T3, and T4 levels, your doctor can provide the best possible solution for your individual case, helping you balance these crucial hormones so you can stay healthy and comfortable.
Changes to your TSH levels can give you an early clue that there's something wrong with your thyroid. The earlier you can diagnose this problem, the less discomfort you'll ultimately suffer. Keeping your thyroid hormones balanced will support your heart health, reproductive health, and much more. If you think that you may need a TSH blood test, talk to your doctor about your symptoms now.
Could Thyroid Medication Cause Insomnia and Dangerous Weight Loss?
For many people, synthetic thyroid hormone and similar medications can be a real lifesaver. They counteract the effects of low thyroid hormone production, helping improve energy levels, mood and overall quality of life. Thyroid medication dosing isn't an exact science, however. In some cases, people with may receive too much medicine, causing them to suffer from anxiety, weight loss, insomnia and other symptoms similar to the ones experienced by people with over-active thyroid glands.
Most of the symptoms found in people who produce too much thyroid hormone are simply the opposite of those found in people with low hormone levels. Hyperthyroidism sufferers often feel anxious and jittery, have trouble sleeping, feel warm in chilly rooms and have a fast heartbeat. They can also suffer from unusual aches and pains. These symptoms can also be the result of being prescribed too high a dose of thyroid medication.
Potential Side Effects of Thyroid Medication
Since thyroid medication is simply a hormone replacement, it doesn't usually produce many side effects. In most cases, patients simply return to feeling normal. Taking too much thyroid medication can produce problems that are similar to those experienced by people with over-active thyroid glands, however. These people may find that they suffer from headache and chest pain, that they have a very rapid heartbeat, and that they lose weight despite eating normally. Sleep disturbances, digestive problems, sweating, trembling and anxiety are also common.
Patients who think that their doses of thyroid hormone are too high, or who believe that they have been misdiagnosed with under-active thyroid should temporarily discontinue medication use. This can cause a return of symptoms, so it's a good idea to do it under a doctor's supervision. Within two to three weeks of discontinuing the medication, these patients can have their thyroid and TSH levels tested again for a new diagnosis. It is also possible to have a blood test performed while still on the medication, but this requires that doctors and patients include the potential medication effects in their analysis of the results.
Patients who feel that their thyroid medication is causing unplanned weight loss and insomnia should take action right away. Getting a blood test and talking to their doctors can help them find the correct balance and avoid more serious health issues later on. While most thyroid diagnoses are correct, there is still some room for error, and correcting that error could be the first step to a healthier, happier life.
Maintaining Healthy Thyroid Hormone Levels
The thyroid is a tiny little gland that has a huge impact on the body. The thyroid gland is responsible for the secretion of hormones that regulate the body's metabolism and growth and development, among many other critical functions. Irregularities in thyroid function can have serious and wide-ranging effects on health and well-being – and they often go undetected. That's why knowing about thyroid testing is important. If you are suffering an undiagnosed thyroid disorder, here are 7 benefits of regulating your thyroid hormones can change your life:
Better Weight Control - hypothyroidism, the most common thyroid disorder, occurs when the thyroid gland produces insufficient amounts of thyroid hormones. The result is an overall slowing of all body functions, including metabolism. When the metabolism slows, the body burns fewer calories. This often results in weight gain, as well as significant difficulty in losing those extra pounds.
Hyperthyroidism, on the other hand, occurs when the thyroid gland produces abnormally high amounts of thyroid hormones. This results in a speeding up of body functions, including metabolism. This can cause dramatic weight loss, despite a healthy or even increased appetite, and being significantly underweight can be just as dangerous to health as being overweight.
So for people who have undetected thyroid problems, the benefits of thyroid testing and appropriate treatment often include greater success in reaching and maintaining a healthy body weight.
Better Cholesterol Control - one of the most common side-effects of hypothyroidism, or under-active thyroid, is high cholesterol levels, a major risk factor for cardiovascular disease. If undiagnosed thyroid problems are fueling high cholesterol levels, thyroid testing and treatment is essential to lowering cholesterol.
Higher Energy Levels - both hypothyroidism and hyperthyroidism can cause chronic fatigue, often combined with muscle aches and weakness, issues that greatly impact quality of life for those with undiagnosed thyroid problems. For that reason, one of the most frequent benefits of thyroid testing and treatment cited by patients is increased energy – which leads to a greater sense of well-being and productivity.
Sharper Mind - another common symptom of undiagnosed thyroid issues is a feeling of “brain fog.” Patients often describe problems that include forgetfulness, difficulty with focus and concentration, and a general feeling of mental slowness. These symptoms also typically improve once thyroid problems are properly diagnosed and treated, so a sharper mind is often one of the benefits of thyroid testing.
Improved Emotional Health - levels of thyroid hormones that are too high or too low can affect emotional health, causing issues that include depression, anxiety, irritability and mood swings. Setting those levels right can resolve those issues, so better emotional health and well-being is often achieved through proper diagnoses and treatment of thyroid disorders – which, of course, begins with thyroid testing.
Improved Skin, Hair and Nail Health - untreated thyroid disorders can cause skin problems, such as extreme dryness, thinning, thickening or inflammation in the skin. Nails can become dry and brittle, or may thicken and/or become discolored. Hair may become dry, thin and brittle, or become coarse. Hair loss is also common, and may occur in the eyebrows as well as the head. Detection and treatment of underlying thyroid problems can restore the health skin, hair and nails – improving both comfort and appearance.
Improvement of Menstrual and/or Fertility Problems - in women, untreated thyroid disorders can affect the reproductive system. Low levels of thyroid hormones can cause heavy bleeding during menstrual periods, irregular periods, decreased or absent ovulation and a significant increase in miscarriage risk during pregnancy. Too much thyroid hormone can cause menstrual periods to be lighter and shorter than normal, and may result in missed periods. Since restoring the body's proper balance of thyroid hormones can improve these problems, reduced improved reproductive health and fertility can be counted among the many potential benefits of thyroid testing.
Other potential complications of untreated thyroid disorders include chronic constipation or diarrhea, vision changes, increased glaucoma risk, fluid retention, increased risk of hypertension and heart disease, and increased risk of diabetes, among others.
The bottom line is this: Since thyroid problems can be largely asymptomatic in the initial stages or may present symptoms that mimic other common health issues, regular thyroid testing is essential to ensuring that your health is not affected by undetected thyroid disease. The American Thyroid Association recommends that all adults be screened for thyroid disorders at least every 5 years, and that people with thyroid risk factors, such as a family history of thyroid disorders, should be tested more frequently.
Preventing Thyroid Problems in Women
Since the thyroid gland regulates metabolism and energy, thyroid disorders have wide-ranging consequences throughout the body, affecting body weight and composition, mental, cognitive and emotional health, reproductive health, cardiac health and function, among many other aspects of health and well-being. Thyroid disorders, once considered fairly rare, have been diagnosed at increasing rates in recent years. Women make up the majority of those affected, with one of every eight experiencing thyroid problems, according to the American Thyroid Association. Given the prevalence of thyroid problems in women, it is important for women to know how to protect thyroid health to lower the risk of suffering from a thyroid disorder.
While the risk of thyroid problems in women cannot be eliminated entirely, there are number of preventive measures women can take to protect thyroid health, such as:
- Eat well – nutritional factors play an important role in optimal thyroid function, so a well-balanced diet is essential to the prevention of thyroid problems in women.
- Don't smoke – Tobacco smoke contains toxins that increase risk of developing thyroid problems.
- Test for thyroid antibodies – testing for antibodies that attack the thyroid gland can catch auto-immune diseases before the thyroid gland is damaged sufficiently to cause thyroid problems.
- Check for food allergies and sensitivities – left untreated, these conditions can increase risk of thyroid dysfunction.
- Limit soy consumption – Over-consumption of soy has been linked to increased risk of thyroid problems in women.
Preventing Thyroid Problems in Men
Although often thought of as a women's health issue, problems with the thyroid gland also present a significant health threat for men, with males accounting for approximately two of every ten people treated for thyroid symptoms.
Men with hyperthyroidism may sweat profusely and be very heat intolerant. Irregular heartbeat and palpitations may occur, and tremors, muscle weakness and weight loss are common. Skin and hair may become thin and brittle and bowel movements more frequent, and there may be swelling or pain in the neck. When Graves' disease is at the root of hyperthyroidism, swelling may occur behind the eyes, causing them to appear enlarged or bulge outwards. One of the most famous sufferers of this disease is the comedian ‘Marty Feldman’ who actually exploited it in his work.
A lesser-known, but very common, symptom of both underactive and overactive thyroid in men is sexual dysfunction. In a study published in the December, 2005 issue of The Journal of Clinical Endocrinology & Metabolism, researchers evaluated the prevalence of sexual dysfunctions in patients with hyper- and hypothyroidism. According to study authors, most men with thyroid disorders experience sexual difficulties, as imbalances in thyroid hormones affect testosterone levels, resulting in thyroid symptoms that can include reduced sex drive, premature or delayed ejaculation and erectile dysfunction. Researchers also note that these issues are rapidly reversed with treatment to normalize levels of thyroid hormones in the system.
If hormone function testing indicates an underactive thyroid gland, synthetic hormone medications are typically used to restore balance. Overactive thyroid symptoms may be treated with medications to suppress hormone production, radioactive iodine to destroy a percentage of hormone-producing thyroid cells, or surgery to remove part or all of the thyroid gland.
Common Questions About Thyroid Disease
The thyroid is an endocrine gland located under the larynx and in front of the trachea. Though it’s often referred to as butterfly-shaped, Ancient Greeks thought it looked shield-like, hence its name – thyroid (the Greek word for shield). Four parathyroid glands are behind the thyroid and assist in overall thyroid function. (Image Source: SCOSA) The thyroid secretes hormones – calcitonin and thyroid hormones – which help control growth, metabolism and the level of calcium in the blood. Calcitonin is a hormone that reduces the level of calcium in blood circulation and releases it into the bones.
How prevalent is thyroid disease in America?
It’s estimated that about 12 percent of adults suffer from some form of thyroid disease or dysfunction. It’s important to recognize the role of this major gland, as thyroid hormone deficiency affects almost all bodily functions.
The most common thyroid diseases are autoimmune in nature, affecting more women than men, especially when women are pregnant. Aging populations are more prone to hypothyroidism and hyperthyroidism, disorders often misdiagnosed because early signs mimic other diseases.
Though relatively rare, thyroid cancer occurs in about two percent of all diagnosed cancer cases and is becoming more dominant, especially among women. The rise is attributed to better screening and early diagnosis.
In developing countries, thyroid disease is still prevalent due to iodine deficiency. Iodine is present in seafood products.
What’s the difference between Hyperthyroidism and Hypothyroidism?
Hyperthyroidism – excessive secretion of thyroid hormones. Symptoms include but are not limited to: cardiac arrhythmia, excessive weakness, weight loss, heat sensations, insomnia, anxiety and goiter formation.
Hypothyroidism – an insufficient secretion of thyroid hormones, with symptoms that include but are not limited to: cold sensitivity, bulging eyes, constipation, excess dryness and thickening of the skin, hair loss, fatigue and formation of a goiter. It affects more than one percent of the general population and about five percent of those over the age of 60.
What are some of the Common Tests that Measure Thyroid Hormone Levels and Detect Disease?
Serum thyroid-stimulating hormone (TSH) is the most sensitive test for primary hypothyroidism and hyperthyroidism. TSH is produced by the pituitary gland. The TSH test, the most valuable thyroid test available according to medical experts, assesses the adequacy of thyroid function in the body. Though “normal” is a variable term, many experts today believe a range level from 0.5 – 2.0 is considered ideal. The level is generally elevated in primary hypothyroidism, thyrotoxicosis and Graves’ disease.
Free T3 – measures the amount of free (unbound) T3; used to determine thyrotoxicosis. Normal range is 2.2 – 4.0 ng/L.
Free T4 – a way to measure thyroid hormone that is available (free) to enter cells; may be used in diagnosing hypothyroidism and thyrotoxicosis. Normal range is 0.9 – 1.6 ng/dL.
Thyroxine-binding globulin (TBG) – measures a protein in the blood (TBG) that is produced in the liver and sticks to thyroid hormone. Normal level is 13-30 ug/mL.
What is a Goiter?
Basically an enlarged thyroid gland, goiters appear in the front part of the neck and can vary in size and type. Centuries ago, a large goiter – highly visible - was considered a sign of beauty, but today we know they can be the result of iodine deficiency along with other causes.
There are three main types of goiter: euthyroid, hypothyroid and thryotoxic, determined by whether the goiter affects thyroid hormone levels and how the levels are affected.
Radioactive iodine and beta-blockers can help shrink the goiter and lower thyroid hormone levels.
What is Thyroiditis?
It means inflammation of the thyroid gland. The most common cause is an autoimmune disorder. Thyroiditis can also lead to hypothyroidism.
What is Thyrotoxicosis?
A condition in which too much thyroid hormone is produced; thyrotoxicosis is not the same as hyperthyroidism, which more accurately means an overactive thyroid gland.
What is Graves’ disease?
Named after a 19th century Irish physician, Robert James Graves, who first published a description of the disease in 1835, Graves’ is an autoimmune disorder that can occur in both sexes and all ages. However, it is more likely to strike younger and middle-aged women.
It results in hyperthyroidism and can cause a goiter to develop
Its cause is an abnormal antibody called TSI (Thyroid-Stimulating Immunoglobulin) that stimulates the thyroid gland to vastly overproduce thyroid hormone, speeding up bodily functions. Symptoms include: rapid heartbeat, emotional changes (from sleep problems to anxiety), unexplained weight loss despite eating more (as appetite increases), enlarged thyroid gland, bruising, fatigue, eye problems, hair loss, intolerance to heat and muscle weakness.
Since the autoimmune root cause of Graves is difficult to control, treatment is geared toward the hyperthyroidism that causes the symptoms. Medications and radioactive iodine are most effective. In severe cases, removal of the thyroid gland (thyroidectomy) may be indicated.
What is Thyroid Cancer and How Common Is It?
Relatively rare compared to other cancers, thyroid cancer presents in one of four types, but two – papillary or follicular – comprise 80 percent of all thyroid cancers diagnosed. Thyroidectomy is generally the treatment prescribed.
Symptoms include: ear pain, trouble swallowing, shortness of breath, hoarseness, and enlargements in the neck or neck pain.
While the cause is generally unknown, one known risk factor is exposure to radiation during childhood. It tends to affect women more than men and more frequently in whites.
Why Should I be screened for Hypothyroidism as an older person?
Signs of hypothyroidism, from weight gain to changes in skin and hair loss, are also the signs of normal aging. Therefore, many healthcare professionals recommend that anyone over the age of 60 be screened for hypothyroidism annually, through a TSH test.
If a thyroid disorder is left undetected, it can also impair the health of an older person to a greater degree since the thyroid affects almost every function in the body. In those with a TSH level greater than 10, treatment with a thyroid hormone may be beneficial. Talk with your healthcare provider once your test results are completed.
What Are Some Common Complications of Thyroid Disease?
Because the thyroid affects the entire body, major organs are impacted by thyroid disease. Among the more common complications are: eye problems (particularly with Graves’ disease) that include lid retraction, resulting in a “staring effect,” gritty, itching, watery eyes and double vision. Depression, anxiety and other mental health issues can follow certain thyroid conditions, as well as heart disease, high blood pressure, insomnia, extreme fatigue and other systemic complications.
Is There a Genetic Link to Hypothyroidism?
Possibly, especially if there is a family history of hypothyroidism. Consider a screening test at Health Testing Centers and discuss any concerns with your healthcare provider.
Some of the media in this article come from National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, with the identification number # N00726.