Your body is 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 functions are controlled to some degree by a delicate hormones. A source for some of these hormonal issues is the thyroid.
“The thyroid is a butterfly-shaped endocrine gland that sits low on the front of the neck,” explains 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.”
The amount of hormone produced in the thyroid is “regulated by the pituitary gland in the brain,” adds Dr. Archana Bindra, an endocrinologist at El Camino Health in Mountain View, California. “The pituitary gland secretes thyroid-stimulating hormone (TSH), which controls the amount of thyroid hormone secreted from the thyroid gland.”
Dr. Irina Azaryan, assistant professor of medicine in the division of endocrinology, diabetes and metabolism at the Ohio State University and Arthur G. James Cancer Hospital in Columbus, says that there are actually two hormones produced by the thyroid: T4 and T3. These hormones “affect the function of virtually every organ system,” from maintaining body temperature to keeping the “brain, heart, muscles and other organs working as they should,” she says.
However, the thyroid sometimes gets out of whack and produces either too much or too little thyroid hormone. When the thyroid isn’t producing enough hormone, that’s called hypothyroidism. A too-active thyroid, on the other hand, causes hyperthyroidism or thyrotoxicosis, says Dr. Anthony F. Firek, a health sciences associate clinical professor of internal medicine with the University of California, Riverside School of Medicine, and director of clinical research for Riverside University Health System in Moreno Valley, California. “Both conditions can cause significant problems for patients, impair quality of life and become life threatening.”
Dr. Joseph Barrera, an endocrinologist and associate medical director at Providence Mission Hospital in Orange County, California, adds that, regardless of whether you’re experiencing hypothyroidism or hyperthyroidism, “in both cases, it’s usually due to an autoimmune reaction in which the individual produces antibodies that either interfere or compromise thyroid function (in the case of hypothyroidism) or enhance and encourage more thyroid hormone production (in the case of hyperthyroidism).”
Thyroid symptoms can vary.
Each person is different in terms of the symptoms of thyroid disease they experience, Firek says. Some patients will show few symptoms, while others might have most of those 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 non-specific and found with other non-thyroid-related conditions,” he says.
The following 12 signs and symptoms could indicate there’s a problem with your thyroid:
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. One concerning and common sign of hypothyroidism (not enough thyroid hormone) 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 you’re 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 heartbeat can lead to heart failure or irregular heart rhythms.
2. Weight and appetite fluctuations
Unintentional 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 where 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 those with an underactive thyroid. For people 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 run-down and exhausted.
Both conditions can also affect muscular strength. This weakness tends to be most apparent in muscles toward the center of the body, so climbing stairs or engaging in activities that also 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 based on the ambient temperature. “Think of it as your cooling and heating system at home but much more complex,” Firek explains.
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. 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 toward sleep. Too much thyroid hormone can lead you to feel jittery and wide awake, causing insomnia and other problems with falling or staying asleep.
Having too little thyroid hormone, however, 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.
8. Bowel problems
Bowel issues can sometimes be related to thyroid problems, says Dr. Thomas Kelley, a family medicine physician with Orlando Health Physician Associates in Florida. “If a person has an underactive thyroid, it can cause the gut to be lazy and not want to be stimulated, so constipation can be one of the first signs someone will notice when they have an underactive thyroid.”
In contrast, if you’re running to the bathroom a lot more frequently, that could be a sign of too much thyroid hormone.
9. Eye issues
Eye issues, including dry eye and altered vision, can occur with thyroid problems. In particular, an autoimmune disorder called Graves’ disease, which causes a range of issues throughout the body because of an overproduction of thyroid hormones, is linked to eye issues.
The American Academy of Ophthalmology reports that thyroid eye disease, or TED, is observed in about 50% of cases of Graves’ disease. TED causes the eye muscles and fatty tissue behind the eye to become inflamed.
This condition “can affect the eyes, causing excess dryness, double vision, bulging of the eyes and, if severe, blindness,” Firek says.
10. A lump in the throat
Also called a goiter, 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.
This abnormal enlargement of the thyroid gland can occur with hyperthyroidism and hypothyroidism, the American Thyroid Association reports. Goiters can also develop in people who have normal thyroid function but who may have an iodine deficiency or another issue. Iodine deficiency is extremely rare in the United States but can lead to an enlarged thyroid. The symptoms of low thyroid, or hypothyroidism, could also be signs of iodine deficiency.
11. Mental and mood changes
Brain fog or other cognitive changes, irritability, depression or other mood issues can all be signs of problems with the thyroid. In some cases, the mental health effects of thyroid hormone disorders can mimic psychiatric issues, like attention deficit and hyperactivity disorder.
In others, “thyroid disturbance and other endocrine problems can mimic signs and symptoms of ADHD,” says Dr. Eugene Arnold, professor emeritus in the department of psychiatry and behavioral health at the Ohio State University College of Medicine in Columbus.
ADHD is often associated with kids, but it can persist in adults. For some people who experience symptoms, a thyroid issue, not ADHD, could be causing the inattention and distractibility that are often hallmarks of ADHD.
12. Menstrual changes in women
The thyroid gland heavily influences the menstrual cycle. 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 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.
Risk factors
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 via simple bloodwork. These values help assess the levels of thyroid hormone circulating in your blood.
When to see the doctor
Kelley recommends seeing a doctor if any of the above symptoms have been occurring for more than just a few days without another obvious explanation. And if you notice any change in the size or appearance of the gland or the development of any nodules or growths on the gland — which typically show up as a lump in the throat — that’s also a good reason to book a visit with your health care provider, he says.
These visits are also necessary “if you have a family history of thyroid disease, or if you have any of the foregoing symptoms for more than three months,” Salas-Whalen adds.
Monitoring your thyroid health should also become part of your annual checkup. “The thyroid gland should be routinely examined once each year during an overall wellness exam or physical, and lab tests may be necessary if further investigation is indicated,” Kelley says.
What causes thyroid problems?
“Hyperthyroidism can be caused by Graves’ disease, an autoimmune disease that usually presents as a goiter, or enlarged thyroid gland,” Bindra says. “Patients with Graves’ disease typically experience thyroiditis, which is inflammation of the gland, or they might develop a growth on the thyroid called a nodule, which leads to excess hormone release. Several medications can also interfere with the amount of thyroid hormone released.”
Hypothyroidism, on the other hand, can be caused by another autoimmune condition called Hashimoto’s thyroiditis. Treatment for hyperthyroidism — such as surgical removal of the thyroid, radioactive iodine treatment or medications that interfere with hormone release — can also lead to hypothyroidism.
Thyroid diseases are treatable.
The good news is that many thyroid issues can be treated and controlled, and a variety of thyroid medications may be available.
“Depending on the underlying condition, treatment may include medication, surgery, radiation therapy or close observation with routine testing to monitor the problem,” Kelley says.
Salas-Whalen notes that “if a patient is suffering from low thyroid hormone levels, they’ll be prescribed synthetic thyroid hormone,” called levothyroxine. But if you’re producing too much thyroid hormone, “we can prescribe medication that regulates the production of said hormones,” she says.
Once treatment is started, symptoms will usually improve within a few months, Bindra adds.
Azaryan says that in some cases of an overactive thyroid, radioactive iodine therapy — where you take an oral capsule containing a specific type of iodine that shrinks the thyroid gland and reduces the amount of hormone it releases — or surgical removal of the thyroid gland might be indicated.
She also notes that while eating a healthy balanced diet is always a good idea, “there is no special diet and/or vitamin that eliminates thyroid disease. Talk to your doctor about any supplements or diets you are thinking about using. Supplements are rarely a part of the standard care because there is not strong evidence that they are effective and safe.”
No matter the specifics of the problem, 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. Sleep issues.
8. Bowel problems.
9. Eye issues.
10. A lump in the throat.
11. Mental and mood changes.
12. Menstrual changes in women.
More from U.S. News
Best Foods for Healthy Hair Growth
What Are Early Warning Signs of Thyroid Problems? originally appeared on usnews.com
Update 04/17/23: This piece was previously published at an earlier date and has been updated with new information.
