The thyroid is a small gland found at the front of your neck, just below the larynx. Along with the pituitary gland, it is a crucial component of the human endocrine system and controls the body’s metabolism. Your metabolism is the rate at which your body uses energy converted from food. The thyroid produces two vital hormones, T3 (triiodothyronine) and T4 (thyroxine), that control or influence several critical bodily processes.
There are a few ways that the thyroid can begin to become dysfunctional. Some of the most common thyroid disorders include Hashimoto’s Thyroiditis, Graves’ Disease, hyperthyroidism, and hypothyroidism.
Hyperthyroidism
Hyperthyroidism is a thyroid condition that is characterized by an overactive thyroid. When a patient suffers from hyperthyroidism, their thyroid produces excess thyroxine, the primary hormone secreted by the thyroid gland. This results in an increased metabolic rate.
Hyperthyroidism Causes
There are several potential causes of hyperthyroidism; however, the most common cause is Graves’ Disease. Other possible causes of hyperthyroidism include:
- Thyroid nodules
- Thyroiditis (inflammation of the thyroid)
- Postpartum thyroiditis
- Excess iodine consumption
- Amiodarone use
Hyperthyroidism Symptoms
The excess production of thyroxine leads to a variety of symptoms, including:
- Unintentional weight loss
- Increased appetite
- Tachycardia, commonly over 100 beats per minute
- Arrhythmia
- Heart palpitations
- Sensitivity to heat
- Anxiety, irritability, or nervousness
- Tremor, typically in the hands or fingers
- Uncharacteristic sweating
- Changes in menstrual patterns
- More frequent bowel movements or other changes in bowel patterns
- Visibly enlarged thyroid gland, such as a goiter
- Muscle weakness
- Fatigue or loss of stamina
- Troubling falling or staying asleep
- Thinning skin or hair
Treating Hyperthyroidism
If you or your doctor suspect you may have hyperthyroidism, your doctor will begin by running a few tests. These will include:
- A physical exam of the thyroid, where your doctor will perform a preliminary examination of the gland’s size.
- Analysis of the heartbeat using a stethoscope.
- Blood tests to check the level of thyroid hormone, called thyroid function testing.
- Imaging tests, such as Radioactive Iodine Uptake (RAIU) tests, a thyroid scan, or a thyroid ultrasound to analyze your thyroid in real-time.
Once your doctor has confirmed that you are suffering from hyperthyroidism, your doctor will consider a few treatment options:
- Prescription antithyroid drugs, such as methimazole or propylthiouracil, which block your thyroid’s hormone production.
- Prescription beta-blockers, such as carvedilol or labetalol, which do not change the level of hormone production but block the action of the hormones in the body.
- Radioactive iodine treatment is an oral medication that eventually destroys the thyroid to stop hyperthyroidism. Patients consume the radioactive iodine isotopes, which the thyroid absorbs. The radioactive cells shrink your thyroid and lead to reduced thyroid hormone levels. After a short time, the thyroid is usually destroyed, which essentially cures hyperthyroidism. However, patients who undergo this course of treatment will need to take exogenous thyroid hormones to maintain adequate hormone levels.
- Thyroid surgery to remove the gland is called a thyroidectomy. Patients undergoing this treatment course must also take exogenous thyroid hormones to live a normal lifestyle.
Hypothyroidism
Hypothyroidism is a thyroid condition that results in an underactive thyroid. The thyroid in patients who suffer from hypothyroidism does not produce sufficient amounts of thyroid hormones. This lack of thyroid hormones leads to the slowing of the metabolism.
Hypothyroidism Causes
A variety of both primary and secondary factors can lead to hypothyroidism. The most common primary cause of hypothyroidism is Hashimoto’s Disease, a hereditary condition that results in the immune system attacking the thyroid. Some of the other common causes of hypothyroidism include:
- Thyroiditis (inflammation of the thyroid)
- Hyperthyroidism treatments, such as radiation therapy or a thyroidectomy
- Iodine deficiency
- Postpartum thyroiditis
- Congenital hypothyroidism
Hypothyroidism Symptoms
Symptoms of untreated hypothyroidism include:
- Fatigue
- Numbness or tingling in the hands
- Constipation
- Unexpected weight gain
- Unexplained muscle soreness throughout the body
- Muscle weakness
- Elevated blood cholesterol levels
- Depression
- Reduced tolerance to cold temperatures
- Dry, thin skin and hair
- Decreased libido
- Frequent and heavy menstrual periods
- Physical changes to your face, such as droopy eyelids or puffiness
- Lower and hoarser speaking voice
- Brain fog or memory issues
Treating Hypothyroidism
To confirm you are suffering from hypothyroidism, your doctor will likely perform a blood test called the thyroid stimulating hormone (TSH) test. Diagnosing hypothyroidism can be difficult without the TSH test since many symptoms overlap with other conditions.
Typically, treatment involves the daily use of oral synthetic thyroid hormones, particularly levothyroxine. This medication increases blood hormone levels, reducing or eliminating symptoms of hypothyroidism. This treatment will usually lower elevated blood cholesterol levels and help the patient lose any weight they gained as a result of the disorder.
The medication will need to be taken as directed, and regular doctor visits to monitor your blood hormone levels will be necessary. If the medication is not working properly or overtreating the disorder, your doctor will adjust your dosage accordingly.
Hashimoto’s Thyroiditis
Hashimoto’s thyroiditis (also referred to as chronic lymphocytic thyroiditis or Hashimoto’s disease) is an autoimmune disease that causes the immune system to attack the thyroid. Approximately 5% of the United States population suffers from Hashimoto’s thyroiditis, which is most prevalent in middle-aged women. Typically, Hashimoto’s disease leads to hypothyroidism.
Hashimoto’s Thyroiditis Causes
In patients with Hashimoto’s disease, the immune system does not recognize the thyroid as a part of the body. As a result, the immune system uses antibodies to attack the gland. Over time, this damages and inflames the thyroid’s tissues, which reduces its ability to synthesize and secrete thyroid hormones. This dysfunction leads to hypothyroidism. The underlying mechanism that causes autoimmune disorders like Hashimoto’s disease is still unknown.
Hashimoto’s Thyroiditis Symptoms
Often, patients suffering from Hashimoto’s disease will not notice symptoms in the early stages. Typically, the first symptom that patients notice is an enlarged thyroid, called a goiter. Once the disease progresses, patients may suffer from the following symptoms, many of which overlap with hypothyroidism:
- Fatigue
- Unexplained weight gain
- Depression
- Constipation
- Joint pain or stiffness
- Muscle pain or stiffness
- Increased perception of cold
- Eye or face inflammation
- Dry or thin hair, nails, and skin
- Heavy and/or irregular menstrual periods
- Infertility
- Lowered heart rate
- Brain fog or memory issues
Treating Hashimoto’s Thyroiditis
To diagnose patients with Hashimoto’s thyroiditis, your doctor may perform tests, such as:
- Thyroid-stimulating hormone (TSH) tests
- Blood T4 test
- Antithyroid antibody test.
- Thyroid ultrasound test
Once diagnosed, your doctor may prescribe a prescription medication for treatment if you are suffering from hypothyroidism due to the condition. If you are not suffering from hypothyroidism, you may not need to be treated to avoid potential side effects of the treatments; however, you will need constant monitoring from an endocrinologist to prevent hypothyroidism development.
If you do need treatment, you’ll likely need synthetic levothyroxine. When used as a treatment for Hashimoto’s disease, synthetic levothyroxine restores normal thyroid functionality.
Graves’ Disease
Like Hashimoto’s disease, Graves’ disease is an autoimmune disease that causes the immune system to attack the thyroid. The primary difference between the two conditions is that Graves’ disease leads to hyperthyroidism, whereas Hashimoto’s disease leads to hypothyroidism.
Graves’ disease is the most common cause of hyperthyroidism, accounting for up to four-fifths of all cases; however, the disease is still relatively rare, affecting approximately 1.2% of the United States population.
Graves’ Disease Causes
Graves’ Disease affects specific populations at a higher-than-average rate. Populations that are at an elevated risk for Graves’ Disease include:
- Women
- People between the ages of 30 and 50
- Patients with a family history of thyroid problems
- People who smoke cigarettes
- People who suffer from other autoimmune disorders, such as rheumatoid arthritis, lupus, type-1 diabetes, celiac disease, or vitiligo
Graves’ Disease Symptoms
Patients suffering from Graves’ disease may not notice symptoms initially, as they typically appear gradually. Some symptoms patients may experience include:
- Heart palpitations
- Anxiety, nervousness, or depression
- Shaking
- Unexplained weight loss
- Increased appetite
- Diarrhea or frequent bowel movements
- Thin, warm, and/or moist skin
- Reduced tolerance for heat
- Increased perspiration
- Trouble falling or staying asleep
- Goiter
- Thin or brittle hair
- Hair loss
- Menstrual changes, such as irregular periods
- Muscle weakness
- Irritated or gritty eyes
- Bulging eyes
- Sensitivity to light
- Inflammation around the eyes
- Pain or pressure in or behind the eyes
- Blurry or double vision
Treating Graves’ Disease
Your doctor will perform one of the following tests to confirm your Graves’ disease diagnosis:
- Thyroid blood tests
- Thyroid antibody blood tests
- Thyroid uptake test
- Doppler ultrasound blood flow test
If your doctor diagnoses you with Graves’ disease, there are several possible courses of treatment, including:
- Prescription beta-blockers, such as propranolol or metoprolol
- Prescription antithyroid medications, such as methimazole or propylthiouracil
- Radioiodine therapy
- Thyroidectomy
Treating Thyroid Disorders with Associated Endocrinologists
At Associated Endocrinologists, we are proud to offer cutting-edge treatments, such as Thyroid Radiofrequency Ablation, and industry-standard treatments and tests.
If you believe you may be suffering from a thyroid disorder, call Associated Endocrinologists at (248) 775-5272 to schedule a consultation with one of our experienced endocrinologists.