Thyroid Issues? What You Need to Know

Your thyroid has one job. That’s to make hormones that wind their way through your bloodstream and settle in all your organs and tissues. Those hormones determine how well your body burns calories for fuel, regulate your body temperature and how fast your heart beats, and they keep all your vital organs working the way they should.

But for about 20 million Americans, that’s not what happens. That’s the number of people who have some kind of thyroid disease. For such a tiny gland—it’s only about two inches across and looks like a butterfly just above your collarbone—it has a powerful effect on your body.

Some disorders with this organ can lead to problems getting pregnant; pregnancy complications that can affect an unborn child; high LDL cholesterol that can up your risk of heart disease; depression; weight gain or loss; joint or muscle pain; fatigue; slow or rapid heart rate; trouble sleeping; increased appetite; and a higher risk of osteoporosis, a bone-thinning disease that can lead to fracture.

There are two main thyroid disorders that account for the majority of thyroid disease cases:

1. Hormones Gone Wild

Sometimes, the thyroid pumps out hormones like it’s going out of style. That’s a condition called hyperthyroidism, or “overactive” thyroid. You may first notice symptoms when you start losing weight without trying very hard or are feeling tired all the time.

That overwhelming flood of hormones can also trigger irritability, mood swings, rapid and irregular heartbeat, muscle weakness, intolerance to heat and hand tremors. It can affect fertility and the health of your unborn baby.

Untreated, it can also lead to blood clots, stroke, heart failure other heart problems, and osteoporosis, a thinning of your bones that can lead to fracture.

Hyperthyroidism can be caused by an inflammation of the thyroid, nodules on the gland, or the autoimmune disorder called Graves’ disease, or by overconsumption of iodine, the raw material your body uses to make thyroid hormone. Iodine is abundant in some medicines and seaweed-based supplements, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

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Who’s at risk?
Women are two to 10 times more likely than men to develop this condition. You also up your chances if you have a family history of thyroid disease, type 1 diabetes, pernicious anemia, a hormonal disorder called primary adrenal insufficiency, are over 60, or have been pregnant within the past six months.

How is it diagnosed/treated?
A blood test will tell you if your thyroid is producing too much hormone. Your family doctor may order the tests and, if you have hyperthyroidism, may refer you to an endocrinologist for treatment. You may also undergo an ultrasound, CT scan or nuclear medicine test. In one nuclear test, a small amount of a radioactive isotope is either swallowed or injected. The isotope winds up in your thyroid where your doctor can view any abnormalities in the gland via a high-tech instrument called a gamma scanner. This test can help determine what’s causing your hyperthyroidism, which is linked to thyroid nodules (they can overproduce hormones) or Graves’ disease, a condition in which the body attacks and destroys thyroid issue.

Treatment may include:
Radioactive Iodine I-131 Therapy.  You’ll be given a small dose of radioactive iodine to swallow. The iodine will go through your GI tract but will settle in your thyroid where it will start destroying cells, according to the Radiological Society of America and the American College of Radiology. (A radiologist will likely be part of your treatment team.)  The goal is to destroy some or most of the thyroid gland, after which you’ll have to take synthetic thyroid hormone for the rest of your life. This treatment is also used for thyroid cancer, which is rare, occurring in only about 57,000 people a year. It is also rarely fatal.
If you have a nodule or thyroid cancer, you may need surgery to remove the nodule, part or all of your thyroid gland.

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2. Hormones Gone Missing.

Gaining weight even though you’re on a diet? If your thyroid isn’t making enough hormone, you could have unexplained weight gain, as well as a host of other symptoms include fatigue, a puffy face, intolerance to cold, joint and muscle pain, dry skin and hair, hair loss, constipation, depression, a slowed heart rate and fertility problems.

Who’s at risk?
Again, women are at higher risk than men of hypothyroidism. Risk factors include: Being over 60, having other thyroid problems including nodules, and having Hashimoto’s disease, an autoimmune condition in which your own body attacks the thyroid, hampering its ability to make hormones. The symptoms are exactly the same as those for hypothyroidism, according to the Office on Women’s Health at the US Department of Health and Human Services. Women are seven times more likely to have this autoimmune disease than men and it’s most likely to occur in women between the ages of 30-50.

How is it diagnosed and treated?
Blood tests for the presence of thyroid hormones and antithyroid antibodies—the ones that attack your thyroid gland as if it’s not part of your body—are used to detect an underactive thyroid and Hashimoto’s disease. Your doctor may also order an imaging test, such as ultrasound or CT scan.

Treatment may include:
Treatment for hypothyroidism as well as Hashimoto’s disease is usually a prescription for synthetic hormones which you will have to take for the rest of your life, says the American Thyroid Association. You’ll also need your blood levels monitored regularly to make sure your thyroid hormones stay at an even keel.