How Your Thyroid Affects Your Health

When your thyroid gland works properly, releasing thyroid hormone into the bloodstream at the expected rate, you probably never realize it’s doing its job. But when it releases thyroid hormone at a faster or slower rate, you’ll likely notice signs of thyroid disease.

“Thyroid hormone controls a lot of organ systems in the body,” says Dr. Arti Bhan, division head of endocrinology with Henry Ford Health System: “Your body temperature, heart rate, muscle function, brain function, metabolism and bone strength. For a small, butterfly-shaped gland in the front of your neck, it has profound effects if it’s underactive or overactive.”

About 20 million Americans have symptoms of thyroid disorders. They’re more common among women. Some conditions affect older adults, but thyroid problems in women are common among those between the ages of 20 to 50.

“Hypothyroidism can show itself at puberty, pregnancy, menopause,” Dr. Bhan says, “any time the woman is going through a change of any kind.”

Common thyroid problems

Hypothyroidism

The most common thyroid disorder is hypothyroidism, which occurs when the thyroid doesn’t produce enough thyroid hormone. You may feel tired, sluggish, cold or constipated, experience depression, have irregular periods or gain five to 10 pounds.

“The symptoms of hypothyroidism, unfortunately, are not very specific, so at any given time, anyone might have symptoms of hypothyroidism. For instance, not sleeping well for a few days could mean many things,” Dr. Bhan says.

If your doctor suspects hypothyroidism, they will order a blood test called TSH, which measures thyroid hormone levels.

“That’s the best test,” Dr. Bhan says. “People ask for other tests, and it doesn’t make sense. If your TSH is normal, there’s no other test that you need.”

The most common cause of hypothyroidism is Hashimoto’s disease, an autoimmune condition, which requires further testing to diagnose. But thyroid surgery, exposure to radioactive iodine or pituitary gland problems also can cause hypothyroidism.

The treatment is thyroid hormone to help replace what yours isn’t producing. You’ll need to take it daily for the rest of your life.

Hyperthyroidism

About 1 percent of Americans have hyperthyroidism, which speeds up the body’s metabolism, causing rapid heartbeat, weight loss, excessive sweating, tremors and bone problems.

“An overactive thyroid causes what’s called increased bone turnover,” Dr. Bhan says. “It’s leaching the calcium out of your bones, so you’re more likely to develop osteoporosis.”

If your doctor suspects hyperthyroidism, they will order a TSH test and possibly a thyroid scan.

The most common cause of hyperthyroidism is Graves’ disease, an autoimmune disease. But the condition also can be caused by thyroid nodules (see below) or inflammation of the thyroid.

Some people with hyperthyroidism take medication to slow down their thyroid hormone production. Others take beta blockers to slow down the heart rate. Still others must have their thyroids removed with radioactive iodine through surgery. Afterward, they are prescribed thyroid hormone.

“You would need to take it every day for the rest of your life,” Dr. Bhan says.

Thyroid nodules

Thyroid nodules, or lumps, are sometimes found in younger adults. Most are harmless, but 5 to 7 percent are cancerous, so doctors biopsy them.

“If the nodule is not cancerous, then we just follow it periodically with ultrasound or exams,” Dr. Bhan says. “It’s very likely to stay benign.”

Thyroid disease and pregnancy

Hypothyroidism and hyperthyroidism sometimes occur during pregnancy. They may be hard to diagnose because their vague symptoms mimic pregnancy symptoms.

“The patient may be tired, but in pregnancy you’re tired,” Dr. Bhan says. “Patients may say they’re constipated, but again, in pregnancy, constipation is a big issue.”

Doctors still use a TSH test for diagnosis during pregnancy. Knowing your status early is ideal for your health and that of your baby.

For hypothyroidism, thyroid hormone is safe during pregnancy. If you have hyperthyroidism, your endocrinologist will prescribe the best treatment.

“Antithyroid drugs are not as safe and have to be used very cautiously,” Dr. Bhan says. “You have to use a certain kind in the first trimester and then switch to a different kind in the second trimester.”

Postpartum thyroiditis

Some women develop postpartum thyroiditis after pregnancy, especially those with type 1 diabetes or a family history of thyroid problems. Postpartum thyroiditis initially causes hyperthyroidism for several months, then hypothyroidism for several months.

Doctors may prescribe beta blockers for hyperthyroidism, then thyroid hormone for hypothyroidism. After a few months, you’ll be asked to stop taking medication to see whether the problem has resolved.

“Most of the time, people go back to normal, but some may never go back to normal, remaining permanently hypothyroid,” Dr. Bhan says. "For a small, butterfly-shaped gland in the front of your neck, it has profound effects if it’s underactive or overactive." 

 

Categories: Get Healthy

0891Blog Orange Callout2018

Sign up for our eNewsletter

Get HAP’s Balanced Living blog delivered right to your inbox. You’ll get the latest health and wellness news, tips, advice from HAP experts, and helpful ideas to improve your well-being.