Your body’s controlled by hormones.
Hormones are chemicals that dictate many aspects of human health. From when a woman is able to conceive a child, to pregnancy, energy levels and even body temperature — all of these bodily functions are controlled to some degree by a delicate balance of hormones. When they fall out of that optimal balance, you may notice some symptoms and problems, and a source for some of these issues is the thyroid.
“The thyroid is a butterfly-shaped endocrine gland that sits low on the front of the neck,” says Dr. Rocio Salas-Whalen, a triple board-certified endocrinologist and the founder of New York Endocrinology in New York City. “The thyroid gland’s primary function is to produce thyroid hormones, which regulate your metabolism, among other vital body functions like body temperature, muscle strength, menstrual cycle and more.”
But the thyroid can sometimes get off kilter, producing either too much thyroid hormone or too little. When the thyroid isn’t producing enough hormone, that’s called hypothyroidism. A too-active thyroid causes hyperthyroidism or thyrotoxicosis, says Dr. Anthony F. Firek, an endocrinologist with the Riverside University Health System in Moreno Valley, California. “Both conditions can cause significant problems for patients, impair quality of life and become life threatening.”
Symptoms can vary.
The following 12 signs and symptoms could indicate there’s a problem with your thyroid.
“Each person is different” in terms of the symptoms they experience, Firek says. Some patients will show few symptoms, while others might have most of these on the list. If you do have some of these signs, remember it might not be a thyroid issue at all. “Many of these (symptoms) are found with other non-thyroid related conditions,” he adds.
1. Altered heart rate, aka your pulse
“The symptoms that a patient may have are quite numerous and span all of the body systems,” Firek says. But a concerning and common one that could signal hypothyroidism is a slow pulse rate. Thyroid hormones help regulate how frequently your heart beats, and as such, too little hormone can result in a slower rate. In severe cases, this can lead to abnormally low heart rate and coma.
At the other end of the spectrum, an increased heart rate — usually over 90 beats per minute when not exercising — can indicate your thyroid is putting out too much thyroid hormone. Your hands might be shaky as well. In severe cases, this elevated heart beat can lead to heart failure or irregular heart rhythms.
2. Weight and appetite fluctuations
“Unintentional and/or unexplainable weight gain or weight loss” can be an indicator that the thyroid isn’t working properly, Salas-Whalen says. The amount of hormone your thyroid is releasing can also impact how hungry you feel, so you may notice that your appetite has changed. Weight gain and reduced appetite are associated with hypothyroidism, while weight loss and increased appetite can be signs of hyperthyroidism.
3. Hair loss
Both hypo- and hyperthyroidism can lead to hair loss. The disruption of the production of thyroid hormones can change the way hairs develop at the root and may prevent new hair from growing in where an old hair has fallen out.
This can lead to thinning hair on the scalp and eyebrows. In some cases, people with thyroid issues may develop a condition called alopecia areata, which causes the hair to fall out in patches and can cause complete baldness. Alopecia areata is an autoimmune disease, but it may accompany thyroid issues.
In addition, some medications that are used to treat thyroid issues can cause hair thinning.
4. Skin changes
The American Academy of Dermatology reports that several skin-related symptoms are commonly seen in people who have thyroid problems. Dry, cracked skin that’s cool to the touch is often seen in people with an underactive thyroid. For those with an overactive thyroid, increased sweating and flushing of the face may be more prevalent, noticeable symptoms.
5. Fatigue and weakness
Fatigue and weakness can occur in both hyper- and hypothyroidism. Initially, someone with an overactive thyroid gland may feel energetic, but as the condition persists, that flush of energy can disappear and leave them feeling rundown and exhausted.
Muscular strength is also impacted by both conditions. This weakness tends to be most apparent in muscles toward the center of the body, so climbing stairs or activities that use shoulder strength, such as combing your hair or lifting a heavy item, may be impacted.
6. Heat or cold intolerance
The thyroid gland controls your body’s ability to keep warm or cold as needed in the environment you’re in. “Think of it as your cooling and heating system at home but much more complex,” Firek explains.
But when thyroid hormone levels are too high, you may overheat, and when your thyroid isn’t producing enough hormones, you may feel cold all the time.
7. Bowel problems
Increased bowel movements can be a sign of too much thyroid hormone, while constipation could indicate that your gastric motility — or how quickly food and waste moves through the digestive system — has slowed because of not enough thyroid hormone.
8. Eye issues
Eye issues, including dry eye and altered vision, can occur with thyroid problems. In particular, an autoimmune disease called Graves’ disease “can affect the eyes, causing excess dryness, double vision, bulging of the eyes, and if severe, blindness,” Firek says.
9. A lump in the throat
Also called a goiter, a swelling of the thyroid gland can produce a noticeable lump in the throat that may be obvious to touch or sight. “A goiter is just a generic term that indicates an enlarged thyroid gland,” Firek explains.
The term goiter refers to this abnormal enlargement of the thyroid gland, the American Thyroid Association reports, and it can occur with hyperthyroidism and hypothyroidism. Goiters can also develop in people who have normal thyroid function but have an iodine deficiency or another issue. Iodine deficiency is extremely rare in the United States.
10. Mental and mood changes
Brain fog or other cognitive changes, irritability, depression or other mood changes can all be signs of problems with the thyroid. In some cases, the mental health implications of thyroid hormone disorders can mimic psychiatric issues.
11. Sleep issues
Because the thyroid helps regulate your body temperature, it’s also involved in your sleep-wake cycle — your body temperature naturally falls as you head towards sleep. Too much thyroid hormone can lead you to feel jittery and wide awake, causing insomnia and other problems falling or staying asleep.
If you have too little thyroid hormone, however, that can make you feel sluggish and sleepy. Some people with hypothyroidism can get nine hours of sleep a night and still feel groggy in the morning.
12. Menstrual changes in women
The menstrual cycle is also heavily influenced by the thyroid gland. Either hypothyroidism or hyperthyroidism can lead to irregular menses with changes in menstrual flow (heavy or light periods), frequency (how often you’re menstruating) and/or duration (how long your cycle lasts).
Thyroid issues can also make becoming pregnant difficult. “Women with a thyroid condition who plan on becoming pregnant or who are discovered to be pregnant while under treatment must be seen immediately by an experienced obstetrician and/or an endocrinologist for management during pregnancy,” Firek says.
Some people may be at higher risk of developing thyroid problems because of genetic factors or a past history of radiation treatment or surgery in the neck. A history of autoimmune disease can also be a risk factor.
“For some reason, women are at a much higher risk for thyroid conditions,” Firek says, “so, medical providers are generally sensitive to any complaint a female patient may have that might be thyroid related.” Those who have a family or personal history of thyroid disease may also be more likely to develop thyroid problems.
Your doctor can diagnose a thyroid issue by checking thyroid hormone levels. These values help assess the levels of thyroid hormone circulating in your blood.
When to see the doctor
“If you have a family history of thyroid disease or if you have any of the forgoing symptoms for more than three months,” it’s time to make an appointment with your doctor for evaluation and care, Salas-Whalen says.
The good news is that many thyroid issues can be treated and well-controlled. “Thyroid disease is treated according to the symptoms at hand,” Salas-Whalen says. So, “if a patient is suffering from low thyroid hormone levels, they’ll be prescribed synthetic thyroid hormone.” But if you’re producing too much thyroid hormone, “we can prescribe medication that regulates the production of said hormones.”
It’s important to get treated if you do have thyroid issues, Salas-Whalen says, because “proper thyroid function is crucial in order for all of the organs in our body to function normally. Having abnormal thyroid levels can cause many symptoms, some more dangerous than others, but it can be easily treated with medication. I urge patients to listen closely to their bodies and its needs, and to consult a doctor if symptoms persist.”
12 signs your thyroid may be out of whack:
1. Altered heart rate.
2. Weight and appetite fluctuations.
3. Hair loss.
4. Skin changes.
5. Fatigue and weakness.
6. Heat or cold intolerance.
7. Bowel problems.
8. Eye issues.
9. A lump in the throat.
10. Mental and mood changes.
11. Sleep issues.
12. Menstrual changes in women.
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Update 07/08/21: This story was previously published at an earlier date and has been updated with new information.