More Slideshows from eMedicineHealth
Menopause and Perimenopause
Is Your Thyroid Abnormal?
It's hard to tell if you have thyroid abnormalities. You might feel run down and tired, or have what is known as "brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious, or sweat a lot more than usual. All of these are common symptoms of thyroid disorders. The thyroid gland regulates many processes within the body, and women are particularly likely to have disorders that affect the function of this essential gland. Recognizing and treating these conditions is critical for optimum health and preventing long-term health problems.
What Is the Thyroid Gland?
The thyroid gland is located in front of the neck. It has right and left lobes that confer a butterfly-shaped appearance. The hormones produced by this gland control the body’s metabolism, or the processes by which the body uses energy. Disorders that affect thyroid function can either speed up or slow down metabolic processes, which can lead to a wide range of symptoms.
Symptom: Losing or Gaining Weight
Changes in weight can signal an abnormal function of the thyroid gland. Low levels of thyroid hormones (hypothyroidism) can cause weight gain, while unexpected weight loss can signal that too many thyroid hormones are being produced (hyperthyroidism). Hypothyroidism is much more common than hyperthyroidism.
Symptom: Swollen Neck
A goiter is an enlargement of the thyroid gland, As shown here; an enlarged thyroid can be seen as a swelling in the front of the neck. A goiter can occur both as a result of hypothyroidism and hyperthyroidism. It can sometimes also result from tumors or nodules that develop within the thyroid gland.
Symptom: Changes in Heart Rate
The hormones made in the thyroid gland affect almost every organ in the body, including the heart. Hypothyroidism can cause the heart to beat more slowly while hyperthyroidism causes a fast heartbeat. Elevated levels of thyroid hormones also can lead to increases in blood pressure and the sense that your heart is pounding (palpitations).
Symptom: Changes in Mood or Energy
Thyroid disorders can affect emotions, energy, and mood. Hypothyroidism can cause symptoms like depression, tiredness, and feeling sluggish. Hyperthyroidism is associated with sleep disturbances, irritability, anxiety, and restlessness.
Symptom: Hair Loss
Hair loss is a common sign of a thyroid problem. Both too high and too low levels of thyroid hormones can lead to hair loss. The hair typically grows back once the condition is treated.
Symptom: Body Temperature Too Cold or Hot
The thyroid affects regulation of body temperature, So, those with hypothyroidism often report feeling cold. In contrast, people with hyperthyroidism tend to have excessive sweating and an aversion to heat.
Other Symptoms of Hypothyroidism
Other symptoms and signs of hypothyroidism include:
- Changes or abnormalities in the menstrual cycle
- Dry skin and brittle nails
- Tingling and numbness in the hands or fingers
Other Symptoms of Hyperthyroidism
Other symptoms and signs of hyperthyroidism include:
- Problems with vision
- Irregularities in the menstrual cycle
- Trembling hands
- Muscle weakness
Menopause or Thyroid Disorder?
Thyroid disorders can cause symptoms that are mistaken for those of a woman approaching menopause. Both menstrual cycle changes and mood changes can result from the menopausal transition or from thyroid conditions. Blood tests can determine which of these conditions is responsible for your symptoms. It's also possible to have a combination of the two causes.
Who Should Be Tested?
The American Thyroid Association recommends that everyone be screened yearly for thyroid disease starting at age 35. You may need more frequent tests if you have symptoms or risk factors for thyroid disease. Both hypothyroidism and hyperthyroidism are most common in women over the age of 60. A family history of thyroid disease increases your risk of developing thyroid conditions.
Checking the Thyroid and Neck
Examining your neck in the area of the Adam's apple while you swallow can sometimes show if your thyroid is enlarged. Swallow while tipping the head back, and examine your neck and the area above the collarbones. If you see any lumps or bulges, see a doctor.
Diagnosing Thyroid Disorders
Blood tests can diagnose many thyroid conditions. Thyroid-stimulating hormone (TSH) is a hormone that controls activity of the thyroid gland. If your TSH is high, this typically signals that your thyroid function is low (hypothyroidism). Likewise, low levels of TSH suggest hyperthyroidism. Your doctor may also order tests to determine the levels of other thyroid hormones. Imaging studies and tissue biopsies are other tests that are sometimes used to evaluate thyroid problems.
Hashimoto's disease, an autoimmune condition, is the most common cause of hypothyroidism. In this case the immune system mistakenly targets and damages the thyroid gland, so not enough hormones are produced. Hashimoto’s disease is often inherited.
Other Causes of Hypothyroidism
The pituitary gland is located at the base of the brain. It controls the functions of many other glands in the body, including the thyroid. The pituitary gland produces TSH, which signals the thyroid gland to make thyroid hormones. If there is a problem with the pituitary gland and not enough TSH is produced, hypothyroidism can result. Inflammation of the thyroid and taking certain medications can also cause low thyroid hormone levels.
Graves' disease is the most common cause of elevated thyroid hormone levels. This is another autoimmune condition in which the immune system targets the thyroid gland; in this case, the immune system attack triggers the release of high levels of thyroid hormones. A swelling behind the eyes is one of the characteristic signs of Graves’ disease, as shown here.
Other Causes of Hyperthyroidism
Thyroid nodules are lumps that are found inside the thyroid gland. These lumps can begin producing high levels of thyroid hormones, leading to hyperthyroidism. Large lumps may be obvious, while smaller nodules can be seen with an ultrasound examination of the thyroid.
Thyroid Disorder Complications
Untreated hypothyroidism can raise cholesterol levels and increase your risk of heart attack or stroke. If thyroid hormone levels drop to extreme lows, coma and a life-threatening lowering of body temperature can occur. Other complications of untreated hypothyroidism include a loss of bone density and heart problems.
Treatment for hypothyroidism usually involves taking thyroid hormones in pill form. Symptoms usually improve within a few weeks of beginning therapy. Most of those affected will have to take the thyroid hormones throughout their life. Over time, treatment can result in weight loss, increased energy, and lowering of cholesterol levels.
Antithyroid medication, which attempts to lower the amount of thyroid hormone produced, is the most common treatment for hyperthyroidism. Many people need to take this medication over the long term. You may need other kinds of medication to treat certain symptoms like tremors or fast heart rate. Radioactive iodine is a treatment option that destroys the thyroid gland over a period of weeks. After the gland has been destroyed, it is necessary to take thyroid hormones in pill form.
Thyroid Disorders and Surgery
Surgery to remove the thyroid gland is recommended for hyperthyroidism only when antithyroid drugs do not work, or if there is severe enlargement of the gland. Surgery can also be used to treat thyroid nodules or tumors. After surgical removal of the gland, most people need to take thyroid hormones in pill form.
What About Thyroid Cancer?
Thyroid cancer is not common, and it is among the least deadly types of cancer. A lump or swelling in the thyroid gland is the most common sign, and only about 5% of thyroid nodules are malignant (cancerous). Thyroid cancer is typically treated by surgery followed by radioactive iodine therapy or radiation therapy.
More Reading on Thyroid Disorders