An estimated 20 million Americans have some form of thyroid disease—roughly 12% of the population—and most of them don’t even know there’s a problem. “That,” says Dr. Ibitoro Osakwe, Chief and fellowship program director of the Division of Endocrinology and Diabetes at Baystate Medical Center, “is because the symptoms of the most common thyroid diseases, hypo- and hyperthyroidism, are easy to confuse with the symptoms of other common conditions and certain stages of life.”
Before we dive into those conditions, let’s first look at what exactly the thyroid is and does.
What Does Your Thyroid Do?
The thyroid is a small butterfly shaped gland located in the middle of the lower neck. The function of the thyroid gland is regulated by another hormone called Thyroid Stimulating Hormone (TSH), which comes from the pituitary or “master” gland. A properly functioning thyroid produces thyroid hormone, thyroxine and triiodothyronine (T4 and T3). that regulate the body’s metabolism—the rate at which the body produces energy from nutrients and oxygen—and affects critical body functions, such as cholesterol levels, mood, bone density, and heart rate In fact, thyroid hormone influences every cell, tissue, and organ in the body. That’s a lot of power for a little organ.
According to Osakwe, “Most people with normal thyroid function fall within a known range of thyroid hormone levels (TSH, FT4 and FT3) If your body is producing the right amount, all is well. But, if for some reason your body starts to produce too much or too little, it can lead to thyroid disease.”
Who is at Risk of Thyroid Disease?
Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones. Thyroid disease can affect anyone — men, women, infants, teens, and the elderly. You may be born with it, or it can develop as you age. While anyone can have thyroid disease, it most often occurs in women, often after menopause.
Other factors that put you at higher risk of developing a thyroid disease include:
- A family history of thyroid disease
- Certain medical conditions including Type 1 diabetes, lupus, rheumatoid arthritis, and pernicious anemia
- Use of medication high in iodine
- Being over age 60, especially so for women
- Previous history of a thyroid condition or cancer
What are Hypothyroidism and Hyperthyroidism?
The two most common thyroid diseases, hypo- and hyperthyroidism represent the extremes of TSH production.
“Hypothyroidism is when the thyroid is underactive and doesn’t produce enough thyroid hormone (T4 and T3)” says Osakwe. “On the other end of the spectrum, is hyperthyroidism which occurs when you have an overactive thyroid that produces too much T4 and T3.” Both conditions can be caused by other diseases that impact the way the thyroid gland works.
Here’s how the symptoms differ:
Hypothyroidism
Symptoms of hypothyroidism can be different for different people, especially in the earliest stages. However, some common symptoms that occur when low levels of thyroid hormone slow down some or your body’s systems include:
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Feeling tired
- Weight gain
- Muscle weakness
- Forgetfulness
- Feeling cold or intolerant of the cold
- Constipation
- Dry skin
- Elevated cholesterol levels
- Thinning hair
- Hoarseness
Learn more about hypothyroidism.
Hyperthyroidism
Hyperthyroidism can be hard to recognize as some of the most common symptoms of are a lot like other conditions. They can include:
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Feelings of anxiety, irritability, and nervousness
- Difficulty sleeping
- A racing or uneven heartbeat
- Unexplained weight loss
- Larger appetite than usual
- Sensitivity to heat
- Sweating
- More frequent bowel movements
- Thinning skin
- Changes to your period
- Tremors
- Vision problems
Learn more about hyperthyroidism.
How is thyroid disease diagnosed and treated?
Thyroid disease is diagnosed through a simple blood test to check your TSH and thyroid hormone (T4, T3) levels.
“In the case of hypothyroidism, standard treatment consists of a daily use of a synthetic thyroid hormone levothyroxine in the form of a pill,” says Osakwe. “This oral medication works to restore adequate hormone levels and reduce symptoms. For most patients, medication for hypothyroidism will need to be taken for the rest of their life to keep the disease under control. Your doctor will check your TSH levels annually and make adjustments based on the findings.”
Like hypothyroidism, the first step in diagnosing hyperthyroidism is a blood test. “Depending upon the patient and how they’re presenting, a nuclear scan may also be ordered,” says Osakwe.
Treatment for hyperthyroidism is also very individual. Depending upon a patient’s age, physical condition, severity of the disease, the underlying cause and patient preference, potential treatment options may include:
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Daily beta blocker pills
- Anti-thyroid medication, typically taken for a year or more
- Radioactive iodine
- Surgery
Osakwe notes, “Very often, thyroid disease is a life-long medical condition that will need to be managed constantly. Thyroid disease can be tricky, and it may take some time and different approaches to find the right treatment for you. However, once they find a way to control their hormone production, most people with thyroid disease manage to live a full and normal life.”
Learn more about thyroid care at Baystate Health.