Thyroid disease affects all ages and can be present at birth, inherited, medication-induced, related to a past thyroid or inflammatory condition like lupus or Type 1 diabetes, or develop over time like after menopause. Additionally, females are about seven times more likely to have thyroid disease than males.¹ An imbalanced thyroid may have a large effect on your overall mental, physical, and emotional health, but it can be restored with natural and chemical thyroid medications.

What is the thyroid gland?^1,2

The thyroid, a butterfly-shaped gland in the front of the neck, plays a crucial role in regulating the body’s growth, development, and metabolism or creating energy from food. It releases chemical signals or hormones called T3 (triiodothyronine) and T4 (thyroxine). T3 is the active form of thyroid hormone produced from T4 to help with your body’s functioning. T3 and T4 are released into the bloodstream to control weight, body temperature, breathing, and energy. Hormonal release by the thyroid is ultimately controlled by the pituitary gland, a bean-shaped gland located below the brain. The pituitary gland releases thyroid stimulating hormone (TSH) to increase T3 and T4 when it senses levels are low. Hormonal feedback to the pituitary gland plays a role in how many hormones need to be released by the thyroid. However, an improper thyroid functioning can greatly affect your body’s processes. Releasing too much thyroid hormone is known as hyperthyroidism while releasing too little thyroid hormone is called hypothyroidism.

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Types of Thyroid Diseases^1-4

When too much thyroid hormone is released, this is known as hyperthyroidism. This means that the body will use energy too fast, causing you to feel tired, lose weight, and intolerant to heat. Graves’ disease, an autoimmune disease where the body suddenly attacks itself and produces an antibody like TSH, is a common cause of hyperthyroidism. When the thyroid is attacked, excess thyroid hormones are released and the thyroid swells due to the antibodies. Rarely, thyroid cancer or abnormal growth of the thyroid and hormone production leads to thyroid disease.

The opposite of hyperthyroidism is hypothyroidism. Too little release of thyroid hormone causes you to feel tired, gain weight, and affect your sensitivity to coldness. It can be caused by removal of the thyroid; excess hyperthyroidism treatment; too much iodine from contrast dyes for x-rays; amiodarone, a heart rate-controlling medication; and lithium, a mood disorder medication.

Thyroiditis results when the thyroid gland is inflamed or swollen, leading to an increase or decrease in thyroid hormone release. It is characterized by the following three phases: thyrotoxic, hypothyroid, and euthyroid. After the thyroid swells and over produces thyroid hormones in the thyrotoxic phase, there becomes a low supply of thyroid hormones to release or the hypothyroid phase. The hypothyroid phase is longer-lasting and can be permanent. Once the thyroid has recovered and hormone levels are normal, this is known as the euthyroid phase.

Hashimoto’s thyroiditis is an inherited and autoimmune disease where the body thinks the thyroid cells are harmful invaders. This causes the body to attack, damage, and kill your thyroid cells to end hormone production. The causes of Hashimoto’s thyroiditis are unclear, but it is likely related to a family history of thyroid or autoimmune diseases, excess iodine or radiation, and sex hormones since it is more common in females.

Thyroid Disease Symptoms²

An irregular thyroid gland includes a wide range of symptoms from difficulty breathing to hair loss. Yet, it can be difficult to diagnose since the symptoms appear in many other conditions. Hyperthyroidism and hypothyroidism are the two most common thyroid diseases that best categorize the symptoms of disease. Symptoms of excess thyroid hormones or hyperthyroidism include a rapid heartbeat, sweating, bulging eyes or exophthalmos, difficulty sleeping, nervousness, irritability, weight loss, muscle weakness, frequent bowel movements, heat sensitivity, and irregular menstrual periods. The symptoms of a lack of thyroid hormones or hypothyroidism can mostly be thought of as the opposite of hyperthyroidism. Hypothyroidism symptoms include a slow heart rate, hair loss, fatigue, constipation, depression, dry skin, hoarseness, cold sensitivity, and frequent or heavy menstrual periods. Yet, both conditions can result in an enlarged thyroid or goiter due to an imbalance of thyroid hormones.

Thyroid Disease Diagnosis^2,5,6

Diagnosing thyroid disease is done through measuring your symptoms and blood levels of T3, T4, and TSH. If TSH is found to be abnormal, your doctor may assess your blood levels of T3 and T4. A normal TSH level is between 0.4 and 4.0 mIU/L, total T4 is between 5 and 11 mcg/dL, and total T3 is between 100 and 200 ng/dL. Normally when T3 and T4 are low, more TSH is produced to stimulate the thyroid to make more hormones. In the case of hypothyroidism, T3 and T4 are low while TSH is high because the thyroid is abnormally inactive. When excess T3 and T4 are in the blood, they feedback to the pituitary gland to decrease the amount of TSH. If you have hyperthyroidism, T3 and T4 are elevated while TSH is low. This is because the thyroid is overproducing hormones by itself regardless of TSH level regulation.

Thyroid antibodies like thyroglobulin (TG) antibodies can be measured in your blood to determine if you have an autoimmune condition like Graves’ disease or Hashimoto’s thyroiditis.

An imaging procedure like an ultrasound can also be used to view the thyroid gland. After applying a gel and probe to the area, high frequency sound waves are transmitted to show the size of the thyroid. If you are experiencing any of the symptoms or think your thyroid is swollen, you can simply check your thyroid in the comfort of your home. First, locate your thyroid that is above your collarbone or under your Adam’s apple. Then, drink a cup of water while tilting your head back. Look at your thyroid in the mirror as you swallow to see if you notice any lumps. If you notice any lumps, reach out to your doctor for further evaluation.

Thyroid Disease Treatments^5,6

Treatments for thyroid disease have the common goal to either manage symptoms like lowering heart rate or affect the amount of hormones based on hormone levels. Hypothyroidism, Hashimoto’s thyroiditis, and the hypothyroid phase of thyroiditis are mainly treated with levothyroxine, a chemical thyroid hormone to restore your low T3 and T4 levels. If you prefer more natural treatments, medications with pig thyroid gland extracts are available. Furthermore, some dietary supplements you may already be taking like omega-3 fatty acids, zinc glycinate, Withania somnifera, tyrosine, selenium, and vitamins A, D, and E can assist with having a balanced thyroid.

Hyperthyroidism is treated with medications to stop excess thyroid hormone production. Since radioactive iodine can damage your thyroid, leading to hypothyroidism, it can surprisingly be used to treat hyperthyroidism. A more irreversible option to decrease hormone production includes a thyroidectomy or removal of the thyroid, but this requires lifelong thyroid hormone treatment. Since the thyrotoxic phase of thyroiditis is typically short-lived, medications to manage symptoms like rapid heart rate, anxiety, sweating, and inflammation are used.

These conditions are treatable, but therapy is likely lifelong and may change based on your thyroid hormone levels and symptoms. By following an appropriate treatment plan, you will be able to live a normal, healthy life with a controlled thyroid.

Thyroid Disease Complications^5,6

By not taking your medication as prescribed or left untreated, you are at risk for serious complications. If hypothyroidism is not treated, your metabolism slows down and puts you at risk for myxedema coma. This is a medical emergency and can leave you with hypothermia and altered mental status. If hyperthyroidism is not treated, your metabolism is overactive and could lead to thyroid storm. Because of excess thyroid hormones without regulation to keep levels within a normal range, your heart rate, blood pressure, and temperature increases to risky levels. Thyroid storm can lead to fever, psychosis, delirium, and dehydration.

For more information and support, visit the American Thyroid Association (ATA) and Centers for Disease Control and Prevention (CDC) websites or talk with your doctor or pharmacist today. 

References:

1. Thyroid cancer. Centers for Disease Control and Prevention website. https://www.cdc.gov/cancer/thyroid/index.htm. Accessed July 26, 2021.
2. Thyroid disease. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease. Accessed July 26, 2021.
3. Hypothyroidism (underactive thyroid). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed July 26, 2021.
4. Picture of the thyroid. WebMD website. https://www.webmd.com/women/picture-of-the-thyroid. Accessed July 26, 2021.
5. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014; 24(12): 1670-1751. http://doi.org/10.1089/thy.2014.0028.
6. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016; 26(10): 1343-1421. http://doi.org/10.1089/thy.2016.0029.