By Ernst Lamothe Jr.
An underactive thyroid can affect your life in many ways. Hypothyroidism happens when your thyroid doesn’t create and release enough thyroid hormone into your body.
The effect makes your metabolism slow down and is a common condition.
The thyroid gland is a small organ that’s located in the front of the neck, wrapped around the windpipe. It’s shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat.
“Thyroid disease, whether it is overactivity or inactivity, is pretty common in society,” said Scott Albert, a surgical oncologist at St. Joseph’s Health Hospital in Syracuse. “The issue gets broken down into two aspects either functionally which has various symptoms such as fatigue or anatomical where you have goiters and other growth that is usually managed surgically. It is important to educate people on both issues.”
However the condition does have many stereotypes and misinformation. Albert talks about five aspects of thyroid conditions.
1. Misconceptions
Thyroid-related symptoms can be present in many different medical conditions. Common symptoms include extreme fatigue, brain fog, anxiety, heart palpitations, dry skin, and high blood pressure. Lower-than-normal T4 levels usually mean you have hypothyroidism. However, some people may have increased TSH levels while having normal T4 levels. The thyroid helps regulate the heartbeat so it is not pumping blood too fast or too slow. Yet sometimes thyroid gets blamed for several negative symptoms in your overall health.
“We get people who struggle with common symptoms that can be attributed to the thyroid glands like weight loss or hair issues that are not always because of thyroid issues,” said Albert. “We perform blood tests and if your thyroid labs come back in the normal limits then generally your issue doesn’t involve your thyroid. We have to move on to another diagnosis if the numbers are not elevated.”
Also a lot of people assume that family history plays no part, which is incorrect.
“One of the main trends is that thyroid issues run in the family,” added Albert. “The autoimmune continue is something that can be hereditary and someone that has rheumatoid arthritis is also someone prone to having autoimmune issues.”
2. Symptoms
Many of the symptoms for thyroid are universal. Thyroid-related symptoms can be present in many different medical conditions. Common symptoms include extreme fatigue, brain fog, anxiety, heart palpitations, dry skin, and high blood pressure. Lower-than-normal T4 levels usually mean you have hypothyroidism. However, some people may have increased TSH levels while having normal T4 levels. The thyroid helps regulate the heartbeat so it is not pumping blood too fast or too slow. In addition, some may confuse hypothyroidism with hyperthyroidism. The latter, which is diagnosed as an overactive thyroid, has symptoms that include nervousness, anxiety, irritability, difficulty sleeping, fatigue, sensitivity to heat and muscle weakness.
“You can experience a significant decrease in energy and increase in fatigue with hypothyroidism. When those symptoms worsen and don’t go away, that may be a reason to get your thyroid checked,” said Albert. “People with hyperthyroidism may experience weight loss, heart palpitations and tremors because your body is producing too much of the hormone.”
3. Causes
Often times hypothyroidism is caused by a condition called Hashimoto’s thyroiditis where a patient’s immune system attacks and destroys the thyroid. Hashimoto’s disease is the most common cause of hypothyroidism.
“Hashimoto’s disease is an autoimmune disease that primarily affects middle-aged women but can also occur in men and women of any age and in children,” said Albert.
In cases of hyperthyroidism, the most common diagnosis is Graves disease. Graves’ disease is caused by a malfunction in the body’s disease-fighting immune system. It’s unknown why this happens. The immune system normally produces antibodies designed to target a specific virus, bacterium or other foreign substance. In Graves’ disease, the immune system produces an antibody to one part of the cells in the hormone-producing gland in the neck Although Graves’ disease may affect anyone, it’s more common among women and in people younger than 40.
A diagnosis is made with a physical examination and laboratory tests that measure the amount of thyroid hormone. Blood tests that measure thyroxine and thyroid-stimulating hormones can confirm the diagnosis. High levels of thyroxine and low or nonexistent amounts can indicate an overactive thyroid. Occasionally if a patient feels a lump on their neck or throat an endocrinologist will perform an ultrasound or a biopsy.
4. Treatment
For an underactive thyroid, doctors prefer to prescribe levothyroxine. It can also be used to help decrease the size of enlarged thyroid glands, often called a goiter, and to treat thyroid cancer.
Levothyroxine comes as a tablet and a capsule to take by mouth. It usually is taken once a day on an empty stomach, 30 minutes to one hour before breakfast.
In rare cases, a doctor can perform a thyroidectomy, which removes most of your thyroid gland. Risks of this surgery include damage to your vocal cords and parathyroid glands.
“If you take a portion of the thyroid you can set up a case for scarring and then you have to go back if there are more issues,” said Albert. “If it is thyroid cancer, we will eliminate the lymph nodes around the area.”
Thyroid cancer can be treated with radioactive iodine treatment and no chemotherapy.
5. Diet
When it comes to diet and food, thyroid treatments have mixed messages. Some believe in iodine treatments. Iodine is an element that is needed for the production of thyroid hormone. The body does not make iodine, so it is an essential part of your diet. If you do not have enough iodine in your body, you cannot make enough thyroid hormone, according to the American Thyroid Association. Remedies such as iodine supplements are not viewed as necessary if you live in the United States or most developed countries.
“I don’t want to dispel that diet can have an impact, but significant thyroid issues in various countries come about because of the lack of iodine in their diet. We iodized salt so that isn’t an issue in the U.S.”
