Thyroid Health Guide

Your thyroid is a small, butterfly-shaped gland in your neck that plays an enormous role in your overall health. When your thyroid isn’t functioning properly, it can affect virtually every system in your body. Understanding thyroid conditions can help you recognize symptoms early and work with your healthcare provider to find effective treatment.

What Is the Thyroid?

The thyroid gland is located at the base of your neck, just below your Adam’s apple. Despite its small size, it produces hormones that regulate your metabolism, the process by which your body converts food into energy. Thyroid hormones affect your heart rate, body temperature, weight, energy levels, and much more.

Thyroid disorders are extremely common, affecting an estimated 20 million Americans. Women are five to eight times more likely than men to develop thyroid problems. Many people with thyroid conditions are unaware they have one because symptoms can be vague and develop gradually.

Main types of thyroid conditions:

• Hypothyroidism - Underactive thyroid producing too little hormone
• Hyperthyroidism - Overactive thyroid producing too much hormone
• Hashimoto’s Thyroiditis - Autoimmune condition causing hypothyroidism
• Graves’ Disease - Autoimmune condition causing hyperthyroidism
• Thyroid Nodules - Lumps in the thyroid, usually benign
• Thyroid Cancer - Malignant growth in the thyroid gland
• Goiter - Enlarged thyroid gland

Causes and Risk Factors

Different thyroid conditions have different underlying causes.

Hypothyroidism causes:

• Hashimoto’s thyroiditis (most common cause)
• Surgical removal of part or all of the thyroid
• Radiation treatment to the head, neck, or chest
• Certain medications (lithium, amiodarone)
• Iodine deficiency
• Pituitary gland disorders
• Congenital thyroid problems

Hyperthyroidism causes:

• Graves’ disease (most common cause)
• Overactive thyroid nodules
• Thyroiditis (inflammation causing hormone release)
• Excessive iodine intake
• Too much thyroid medication
• Noncancerous pituitary tumors

Risk factors for thyroid conditions:

• Being female
• Age over 60 (for hypothyroidism)
• Family history of thyroid disease
• Personal history of autoimmune disease
• Previous thyroid surgery or radiation
• Pregnancy or recent childbirth
• Smoking
• Excessive iodine exposure

Common Symptoms

Thyroid symptoms can be subtle and easily attributed to other causes. Hypothyroidism and hyperthyroidism have opposite effects on the body.

Hypothyroidism (underactive thyroid) symptoms:

• Fatigue and sluggishness
• Increased sensitivity to cold
• Unexplained weight gain
• Dry skin and hair
• Hair loss
• Constipation
• Muscle weakness and aches
• Depression
• Memory problems and difficulty concentrating
• Slowed heart rate
• Elevated cholesterol
• Puffy face and swelling
• Heavier or irregular menstrual periods
• Hoarseness

Hyperthyroidism (overactive thyroid) symptoms:

• Rapid or irregular heartbeat
• Unintentional weight loss despite increased appetite
• Nervousness, anxiety, and irritability
• Trembling in hands and fingers
• Increased sweating and heat sensitivity
• Changes in menstrual patterns
• Increased bowel movements
• Enlarged thyroid gland (goiter)
• Fatigue and muscle weakness
• Difficulty sleeping
• Thinning skin
• Fine, brittle hair
• Eye problems (bulging eyes in Graves’ disease)

Diagnosis

Thyroid conditions are diagnosed through a combination of physical examination, symptom evaluation, and blood tests.

Diagnostic methods:

• Physical examination - Checking for thyroid enlargement, nodules, or tenderness
• TSH test - The primary screening test; TSH levels rise when thyroid hormone is low (hypothyroidism) and fall when thyroid hormone is high (hyperthyroidism)
• T4 and T3 tests - Measure actual thyroid hormone levels
• Thyroid antibody tests - Detect autoimmune thyroid conditions (Hashimoto’s, Graves’)
• Thyroid ultrasound - Images the gland to check for nodules or structural abnormalities
• Radioactive iodine uptake test - Measures how the thyroid uses iodine
• Thyroid scan - Shows the size, shape, and position of the thyroid
• Fine needle aspiration biopsy - Tests thyroid nodules for cancer

Regular thyroid screening is recommended for women over 35 and anyone with risk factors or symptoms.

Treatment Options

Treatment depends on the type of thyroid condition, its severity, and individual factors.

Hypothyroidism treatment:

• Levothyroxine - Synthetic thyroid hormone is the standard treatment. Most people need lifelong daily medication. Dosage is adjusted based on regular blood tests.
• Regular monitoring and dose adjustments are essential
• Take medication consistently, typically in the morning on an empty stomach

Hyperthyroidism treatment:

• Anti-thyroid medications - Methimazole or propylthiouracil to reduce hormone production
• Beta-blockers - To manage symptoms like rapid heart rate and tremors
• Radioactive iodine therapy - Destroys overactive thyroid cells (may lead to hypothyroidism)
• Surgery - Removal of part or all of the thyroid (for large goiters, suspicious nodules, or when other treatments fail)

Thyroid nodules:

• Many require only monitoring
• Surgery if suspicious for cancer or causing symptoms
• Radioactive iodine for overactive nodules

Thyroid cancer:

• Surgery to remove the thyroid
• Radioactive iodine treatment
• Thyroid hormone therapy
• External radiation or chemotherapy in some cases

What You Can Do

While thyroid conditions typically require medical treatment, lifestyle factors can support thyroid health and help manage symptoms.

1. Take medication correctly - If prescribed thyroid medication, take it at the same time each day. Take levothyroxine on an empty stomach, 30-60 minutes before eating. Avoid taking it with calcium supplements, iron supplements, or antacids.

2. Attend regular checkups - Thyroid conditions require ongoing monitoring. Keep appointments and get blood tests as recommended to ensure proper hormone levels.

3. Maintain adequate iodine intake - Your thyroid needs iodine to produce hormones. Most people get enough from iodized salt and a balanced diet. However, don’t overdo it, as excessive iodine can worsen some thyroid conditions.

4. Consider selenium - This mineral supports thyroid function. Good sources include Brazil nuts, fish, meat, and eggs. Discuss supplementation with your doctor.

5. Eat a balanced diet - Focus on whole foods, including fruits, vegetables, lean proteins, and whole grains. Some foods (soy, cruciferous vegetables) may affect thyroid function, but typically only in excessive amounts.

6. Manage stress - Chronic stress can affect thyroid function and worsen symptoms. Practice stress-reduction techniques like meditation, yoga, or deep breathing.

7. Exercise regularly - Physical activity helps manage weight, mood, and energy levels, all of which can be affected by thyroid conditions.

8. Get enough sleep - Fatigue is common with thyroid disorders. Prioritize quality sleep and maintain consistent sleep habits.

9. Be aware of medication interactions - Many medications and supplements can interact with thyroid function or medication absorption. Always inform your doctor about everything you take.

10. Monitor your symptoms - Keep track of how you feel and report any changes to your healthcare provider. Symptom changes may indicate the need for medication adjustment.

When to See a Doctor

Consult a healthcare provider if you experience:

• Unexplained fatigue that doesn’t improve with rest
• Sudden or unexplained weight changes
• Increased sensitivity to heat or cold
• Changes in heart rate (racing or unusually slow)
• Mood changes, depression, or anxiety
• Changes in menstrual patterns
• Visible swelling in the neck
• Difficulty swallowing or breathing
• Hair loss or dry, brittle hair
• Skin changes

Seek prompt medical attention if:

• You have a very rapid heart rate or heart palpitations
• You experience confusion, agitation, or extreme restlessness
• You have a high fever with a known thyroid condition (possible thyroid storm)
• You develop severe weakness or difficulty breathing
• You find a lump in your neck

Key Takeaways

• The thyroid gland regulates metabolism and affects virtually every body system, making thyroid health crucial to overall well-being
• Hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) have opposite symptoms but both require treatment
• Most thyroid conditions are highly treatable with medication, though treatment is often lifelong
• Regular monitoring and consistent medication use are essential for managing thyroid conditions effectively