January is Thyroid Awareness Month!
What Is The Thyroid And What Does It Do?
The thyroid is a gland that is butterfly-shaped and is normally found in the lower front of the neck. The thyroid gets signals from the pituitary gland, the “master gland”, which sits in the mid-brain and tells all the glands in the body what hormones to produce.
The thyroid’s job is to make thyroid hormones, which are released into the blood and then carried to the rest of the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
What Are Some Common Thyroid Problems?
The most common thyroid problems are hypothyroidism (low thyroid function), hyperthyroidism (high thyroid function) and thyroid nodules, which are growths in the thyroid gland that can lead to thyroid cancer.
What Is Hypothyroidism?
Hypothyroidism is what happens when the thyroid stops making enough thyroid hormone to meet the needs of the body. This can happen because of a problem in the master gland (pituitary) or the thyroid itself.
The symptoms for hypothyroidism are varied and include:
• Weight gain
• Low energy
• Cold intolerance
• Dry skin, hair loss, brittle nails
• Abnormal menstrual cycles
What Causes Hypothyroidism?
In the United States, the most common cause of hypothyroidism is an autoimmune disease called Hashimoto’s disease. Hashimoto’s disease causes the body’s immune system to attack the thyroid.
Other causes of hypothyroidism include:
• Past surgery to remove part of or all of your thyroid
• Neck radiation such as during cancer treatment
• Pituitary tumors
• Medication side effect
How Can You Check If You Have Hypothyroidism?
The way to test if you have hypothyroidism is to measure your TSH (Thyroid Stimulating Hormone) level. If the level is high, such as a value greater than 10, it means the pituitary gland is working on overdrive to send signals to the thyroid, but the thyroid production of thyroid hormones is not sufficient.
What Can You Do About It?
The standard treatment for hypothyroidism is thyroid hormone therapy with levothyroxine, also known as Synthroid, Tirosent, Levoxyl, which will replace the thyroid hormone your body is not making.
It’s important to know that once you start the medicine or change your dose, it takes 4-6 weeks for the TSH laboratory test to show results.
Fortunately, hypothyroidism is easy to diagnose and treat.
What Is Hyperthyroidism?
Hyperthyroidism is what happens when the thyroid is making too much thyroid hormone. It is usually due to problems within the thyroid gland that make it less responsive to signals from the pituitary gland.
The symptoms for hyperthyroidism are varied and include:
• Weight loss
• Heat intolerance, sweating
• Hair loss
• Palpitations, shortness of breath
• Tremor or shakiness
• Insomnia or anxiety
• Abnormal menstrual cycles
• Importantly, these typical symptoms may not occur in elderly persons.
What Causes Hyperthyroidism?
There are three major causes of hyperthyroidism:
• Graves’ disease: A condition where the body attacks the thyroid and causes it to make extra thyroid hormone than what the body needs.
• Thyroid nodule: A condition where some thyroid nodules make extra thyroid hormone.
• Thyroiditis: An inflammation of the thyroid sometimes cause by a virus or medication. This can lead to extra thyroid hormone in the body due to destruction of parts of the thyroid.
How Can You Check If You Have Hyperthyroidism?
The best course of action to check for hyperthyroidism is to see your doctor. There are several blood tests that are needed to determine what kind of hyperthyroidism you have. You may also need a specialized radiological test called an “uptake scan” to determine what parts of your thyroid are overactive.
What Can You Do About It?
The treatment for hyperthyroidism depends on the cause.
Some treatments may include:
• Pain medicine and steroids for thyroiditis
• Anti-thyroid agents like methimazole for Graves’ disease and overactive thyroid nodules
• Radioactive iodine to destroy the thyroid gland
• Surgery to remove part or all of the thyroid gland
• If the gland is destroyed or removed, then hypothyroidism occurs, requiring treatment with levothyroxine as previously mentioned.
What Are Thyroid Nodules?
Thyroid nodules are very common in the population. The risk of a thyroid nodule is proportional to your age in decades.
• A 20-year-old has a 20% chance of having a thyroid nodule.
• An 80-year-old has an 80% chance of having a thyroid nodule.
Most thyroid nodules are benign and are you do not need to be concerned. Around 70% of all biopsies fall into this category.
A small percentage of thyroid nodules are cancer. Around 3-7% of all biopsies result in a cancer diagnosis. However, most cases of thyroid cancer are treatable with surgery, radioactive iodine and close follow up. It is rare that thyroid cancer would shorten your life expectancy.
Keeping Your Thyroid Healthy
There are no preventive steps you can take to keep your thyroid healthy. However, if you have a family history of thyroid disease, notify your doctor.
Get a screening test for thyroid function (TSH level) measured. If you have symptoms of overactive or underactive thyroid, speak to your doctor about repeat thyroid function testing.
If you are taking levothyroxine for hypothyroidism (low thyroid), try to take your medicine each morning on an empty stomach and wait 1-2 hours before taking other medicines or eating to maximize absorption.
Taking extra iodine or other supplements have not been proven to help the thyroid from becoming abnormal.