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The Ellis Exclusive: Understanding Your Thyroid – What Conditions Can Affect This Small & Mighty Gland?

Do you know which gland influences every cell, tissue, and organ in your body?

Located right above your collarbone in the front of the neck, the thyroid is a small butterfly-shaped gland that produces hormones and regulates the body’s metabolism. Thyroid hormones help control several vital functions of your body, including heart rate, blood pressure, body temperature, and the body’s reaction to other hormones.

When your thyroid isn’t functioning properly, it can impact your entire body. It is estimated that up to 12% of the US population – 20 million people – have a form of thyroid disease, though up to 60% of those affected are asymptomatic and unaware of their condition. Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis, infertility, and diabetes.

In today’s post we hope to spread awareness on different types of thyroid diseases, their symptoms, and treatment options. We’ll particularly focus on the two most common diseases, hypothyroidism and hyperthyroidism. Both conditions are serious and need to be treated by your physician.

Types & Causes of Thyroid Disorders

Thyroid diseases are very common and can affect any sex and age group. These disorders can be present when you’re born – infants are routinely tested at birth – or develop with age.

Thyroid issues depend on whether the gland is under- or over-producing hormones, and some are autoimmune (the body’s immune system is attacking the thyroid gland). The most common types of thyroid diseases are:

  • Hypothyroidism: When your thyroid doesn’t make enough hormones
  • Hyperthyroidism: When your thyroid makes too much hormones
  • Thyroid nodules: Lumps on the gland
  • Goiter: Enlargement of the gland

Who is affected by thyroid disease?

Though the causes of thyroid problems are largely unknown, you may be at a higher risk of developing a thyroid condition if you:

  • Are a woman; women are 5 to 8 times more likely than men to have thyroid problems. ● Are older than 60, especially in women.
  • Have a family history of thyroid disease.
  • Have a medical condition that can predispose to thyroid disease. Such conditions include Type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome, and Turner syndrome.
  • Take medication that’s high in iodine (amiodarone).
  • Have had a past thyroid condition or cancer, including thyroidectomy or radiation.

Specific causes and symptoms of thyroid disease can vary depending on the underlying cause for the disorder. Let’s take a closer look at how you can diagnose and treat hypothyroidism and hyperthyroidism.

Hypothyroidism: An Underactive Thyroid

Hypothyroidism, also known as an underactive thyroid gland, is the most common thyroid disorder and occurs when the gland can’t produce enough of its hormones. This causes some of your body’s functions to slow down – and, if left untreated, can lead to other health issues, such as high cholesterol and heart problems.

The most common cause of hypothyroidism is autoimmune – the production of antibodies that attack the thyroid gland. Thyroid autoantibodies can cause damage to the thyroid gland and cause thyroid atrophy, which can also result in hypothyroidism. This process usually develops over a number of years, but may occur more suddenly.

The symptoms of hypothyroidism are very nonspecific and depend on the severity of the condition. Hypothyroidism may not cause noticeable symptoms in its early stages, instead developing slowly – often over several years. When your metabolism continues to slow however, you may develop more obvious signs.

These symptoms may include: easy fatigue, unexplained weight gain, hair loss, puffy face, hoarse voice, dry skin, constipation, sensitivity to cold, depression, memory loss, muscle aches or cramps, loss of sex drive, and abnormal menstrual flow.

Hypothyroidism is usually diagnosed by testing the blood thyroid-stimulating hormone (TSH) level. This specific blood test measures the level of TSH in the bloodstream.

If the patient is found to be deficient in TSH, medications are prescribed to return the hormone level to normal. This is typically a daily dose of thyroxine (T4). The dose can be periodically adjusted for the optimal TSH level; it may take several weeks after changing the dosage to achieve the new steady-state level for measurement.

Hyperthyroidism: An Overactive Thyroid

Hyperthyroidism is the opposite of hypothyroidism and occurs when the thyroid gland is overactive, causing the gland to produce too much thyroid hormone.
The most common cause of hyperthyroidism is Graves’ disease, affecting nearly 75% of people with an overactive thyroid. This is an autoimmune condition that develops when antibodies mistakenly attack the thyroid gland, causing it to produce excessive thyroid hormone.

Hyperthyroidism can also be caused by nodules on the thyroid. These can be overactive – a condition called toxic nodular goiter – and cause the gland to overproduce its hormones. However, most thyroid nodules are not overactive; instead, these can cause hyperthyroidism by failing to respond to internal control mechanisms for thyroid hormone production.

Like hypothyroidism, symptoms for hyperthyroidism are generic and similar to signs of many other medical conditions.

Common symptoms of hyperthyroidism include: an enlarged thyroid gland, difficulty sleeping, anxiety, sensitivity to heat, fast or irregular heart rate (palpitations), muscle weakness, increased hunger, warm skin, excessive sweating, brittle hair and nails, and patchy hair loss.

Also similar to hypothyroidism, hyperthyroidism is usually diagnosed when a physician checks the TSH level. A T4 Thyroxine and T3 Triiodothyronine test may also be performed to help document the presence of excessive thyroid hormone.

There are several anti-thyroid medications and beta blockers available to effectively treat hyperthyroidism. When medications fail to control the condition, radioiodine therapy or surgery can be used to reduce part or all of the thyroid gland.

Once the thyroid gland is sufficiently reduced by radiation or surgery, the patient must take thyroid replacement medication (thyroxin) for the rest of his or her life, or may develop hypothyroidism as a result.

Other Thyroid Conditions

Studies have found that somatic genetic mutations can occur in thyroid tissues, causing nodules to develop. Thyroid nodules may occur in 3 to 7% of all adults. Most of these nodules are less than 1 cm in size, and can be solitary or multiple. They can be found on ultrasounds in up to 50% of adults.

Benign thyroid nodules aren’t typically life threatening and usually don’t need treatment. Often, nothing is done to remove the nodule if it doesn’t change over time.

Your doctor may run additional tests if there is a risk of cancer; however, only about 4 to 6.5% of thyroid nodules are caused by thyroid cancer. Thyroid cancer is very uncommon, occurring in about 15 in 100,000 people. It is usually diagnosed by a fine-needle aspiration biopsy to determine whether your nodule is cancerous.

Taking Care of Your Thyroid

A healthy thyroid gland is critical to a healthy body. There are a variety of symptoms you could experience if you have a thyroid disease; unfortunately, these can be similar to other medical conditions, or easy to confuse with natural aging.

Because thyroid disease can also be asymptomatic, it is important to have your thyroid evaluated with each routine physical examination. Talk to your primary care physician about your thyroid health should you have any concerns or questions.

Wishing you continued health and wellness always,

Clarence Ellis, MD

Sources
https://www.thyroid.org/media-main/press-room/
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https://www.healthline.com/health/common-thyroid-disorders
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https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659
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