Thyroid gland can be over – or under – active
By: Dan Palmquist, M.D.
The thyroid gland is located on the front of the neck. Its main function is to produce thyroid hormones, which are a pair of chemicals that work to control metabolism. Metabolism is the chemical reactions that occur to convert the food we eat in to the energy our body requires to power everything it needs to do – from keeping our organs running and our heart beating to giving us the energy needed to walk and run.
But, the thyroid doesn’t work alone. The pituitary gland, located at the base of the brain, secretes a thyroid stimulating hormone (TSH) that tells the thyroid how much hormones the body needs. If the thyroid needs to produce more hormones, the TSH level goes up; if the body has enough thyroid hormones, the TSH level goes down.
Sometimes, despite the input of the pituitary gland, the thyroid produces too much – or not enough – hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to a disorder called hypothyroidism.
A number of factors can cause the thyroid to put out too much hormone. The main cause is Graves’ disease, an autoimmune disease that causes the thyroid to become overactive. Hyperthyroidism can also occur when: the thyroid becomes inflamed, nodules – called toxic adenomas – form on the thyroid, the pituitary gland malfunctions or cancerous growths form in the thyroid gland.
Hyperthyroidism tends to run in families and is more common in women than men.
When the thyroid produces too much hormone, your body speeds up. The thyroid may become enlarged, resulting in a goiter. Other symptoms can include: a fast or irregular heartbeat, weight loss, feeling nervous or moody, hand tremors, having fine, soft hair fall out, trouble breathing, feeling hot and sweaty, increased bowel movements, feeling weak or tired and skin that is warm, red and itchy.
Hyperthyroidism is diagnosed based on symptoms and a blood test. Sometimes, a blood test done for a different reason may indicate hyperthyroidism, even when symptoms aren’t present.
Hyperthyroidism is most often treated using radioactive iodine and antithyroid medication. In rare cases, surgery may be needed. After treatment, your doctor will complete regular tests to check levels of TSH and thyroid hormones in your blood to ensure they are at normal levels.
It is important to treat hyperthyroidism, even if it does not cause any symptoms. If left untreated the disorder can lead to serious health issues including heart problems, osteoporosis and in rare cases a life-threatening condition known as a thyroid storm.
Sometimes the thyroid gland does not produce enough hormones. The most common causes for this include: an autoimmune disorder called Hashimoto’s thyroiditis, the removal of the thyroid gland and effects of treatment for hyperthyroidism. Hypothyroidism occurs more often during pregnancy. About two percent of pregnant women in the U.S. get hypothyroidism.
Hypothyroidism tends to run in families and women over the age of 60 are also at increased risk. A history of radiation therapy to the neck or chest also increases risk.
When the thyroid doesn’t produce enough hormones, your body slows down. Symptoms include: pain and tenderness in the thyroid gland, pain when swallowing or turning the head, lethargy, weakness, slowed cognition, feeling down, reduced heart rate, tingling and numbness in the hands, heavy menstrual periods, increased sensitivity to cold, development of a goiter, high cholesterol, constipation, coarse and thinning hair, dry skin and brittle nails. Symptoms of hypothyroidism typically develop gradually over time. Sometimes a person experiences no symptoms at all.
Because of the variety of symptoms, hypothyroidism can be mistaken for depression – especially during and after pregnancy. In older people, it may be confused with dementia or other diseases that cause memory problems. When hypothyroidism is suspected, a health care provider will use a blood test to confirm the diagnosis.
Hypothyroidism is most often successfully treated with thyroid hormone medication. Symptoms reside over time, but often a person will have to continue to take medication to regulate thyroid hormone levels. Some cases of mild hypothyroidism do not require medication treatment, but will warrant ongoing monitoring of hormone levels.
Although the effects of abnormal thyroid hormone production can be unpleasant, most thyroid problems can be managed successfully if properly diagnosed and treated. It is important to work closely with your physician, follow mediation recommendations consistently and have your blood levels monitored regularly to ensure your treatment plan is working for you.
Dr. Palmquist is a board certified family practice physician at Raiter Clinic in Cloquet.