According to the American Thyroid Association an estimated 20 million Americans have some form of thyroid disease and up to 60% of individuals with a thyroid disease are unaware of their condition.
Thy-what? Why is the Thyroid such a big deal?
The thyroid produces hormones that are responsible for many physiological functions in the body including breathing, heart rate, central/peripheral nervous system, body weight, muscle strength, menstrual cycles, body temperature, and cholesterol levels. Basically, the thyroid is crucial to keeping us alive.
What does the Thyroid do?
The thyroid is a butterfly shaped gland located at the middle of your neck and is part of the endocrine system. It’s function is to produce, store, and release thyroid hormones. The thyroid takes iodine from the foods we eat and converts it into two main hormones- Triiodothyronin (T3) and Thyroxine (T4).
The thyroid is controlled by the hypothalamus, a section of the brain, and the pituitary gland, a tiny organ at the base of the brain. The pituitary gland releases a hormone called Thyroid Stimulating Hormone (TSH), which acts on the thyroid to signal the production of thyroid hormones. When T3 and T4 levels are low the pituitary gland releases more TSH to tell the thyroid to produce more hormones. When T3 and T4 levels are high, the pituitary releases less TSH to slow production of these hormones. When the thyroid does not produce enough hormones it is considered hypothyroid and when the thyroid produces too much hormone is considered hyperthyroid. With both hypo- and hyperthyroid conditions, the balance of the chemical reactions in the body is upset.
Causes of thyroid imbalances can include chronic stress, autoimmune diseases, iodine deficiency, certain medications, pregnancy, pituitary disorder, or radiation therapy. There are several symptoms of thyroid problems, but they differ based on whether a person has hypo- or hyperthyroid.
Symptoms of hypothyroidism for both men and women:
- The feeling of persistent exhaustion and/or fatigue, even after a good night’s sleep.
- The thyroid hormone is responsible for metabolism and when there are too little thyroid hormone people can experience unexplained weight gain.
- Many people experience a puffy face, or swelling in the arms or legs. This is caused by an accumulation of fluids beneath the skin.
- Too little thyroid hormone can cause forgetfulness and brain fog.
- Trouble tolerating cold could be due to the fact that metabolism is slowing and less energy is being burned by the cells, which means there is less heat produced. Also, there can be a slowing of circulation due to decreases in blood flow.
- Over time having too little thyroid hormones can cause damage to nerves and this can cause unexplained pain or aching throughout the body.
- There is a slowing of digestion or constipation associated with too little thyroid hormone.
- Dry skin is likely related to a slowing metabolism.
- Dry, brittle, and thinning hair sometimes occurs with hypothyroidism.
- Hypothyroidism can also cause a decrease in sweating.
- Fertility problems can be seen in both men and women, see comments below for more info on this topic.
- If you are feeling down or depressed, it could be due to the impact of too little thyroid hormone on the “feel good” serotonin levels in the brain.
- When thyroid hormone levels are low and TSH levels increase, cholesterol levels also increase.
- Slowed heart rate and other heart problems can occur such as decreased pulse pressure, and accelerated atherosclerosis and coronary artery disease.
- The thyroid hormone can have an impact on other hormones including sex hormones, this can cause decreased sex drive in both men and women.
- If you notice a lump or swelling the neck it could be a sign of a goiter, which is a clear indication that something is causing the thyroid to grow abnormally.
Symptoms of hyperthyroidism for both men and women:
- High levels of thyroid hormone can speed up metabolism and cause unexplained weight loss.
- As the metabolic rate increases, there is an increase in appetite.
- Too much thyroid hormone can cause rapid heart rates and an increase in blood pressure.
- Because thyroid hormones act on other stress hormones in the body, hyperthyroidism can create feelings of anxiety or irritability.
- Hyperthyroidism increases metabolic rate, making the body be in a constant state of “on the go.” This makes it hard to relax and can make sleeping difficult.
- The onset of trembling in the hands and fingers can also occur.
- Increased sweating may be an issue with hyperthyroidism.
- The increase in metabolism also means an increase in burning of fuel, thus an increase in heat and feeling hot.
- Some people develop unexplained muscle weakness, including dropping things or feeling as if the legs may give out.
- Diarrhea or more frequent bowel movements than usual.
- Bulging of the eyes or irritation of the eyes can be caused by an autoimmune disease known as graves disease.
- Just as with hypothyroid, a person may develop a goiter with hyperthyroidism.
Men and women may experience many of the same symptoms, but because the thyroid hormone acts on other hormones, including sex hormones, there are some differences between the two sexes:
Thyroid Imbalances in Men:
Men may experience changes in sex hormone binding globulin (SHBG) (1). SHBG is a bit complicated, but men with hyperthyroidism can experience an increase in SHBG while men with hypothyroidism may experience a decrease in SHBG and an associated reduction in free testosterone. Low testosterone has been linked with low sex drive and erectile dysfunction in men, as well as infertility. Dehydroepiandrosterone (DHEA) can also decrease in males with hypothyroidism. Here’s a link on Low SHBG.
Thyroid Imbalances in Women:
Women with thyroid imbalances may experience menstrual disturbances. In hyperthyroid women, this may be short periods lasting only a few days of extremely light menstrual blood flow. Women may also experience shorter intervals between menstrual cycles (usually considered to be 21 days or fewer). Women with hypothyroidism may experience irregular menstrual cycles (1). Women with both hyperthyroidism and hypothyroidism may also experience infertility. Women who are pregnant with a thyroid disorder may have an increased risk of miscarriage (2).
What to do about a Thyroid Imbalance:
- Get a lab test to check your thyroid function.
- Be sure the lab panel includes TSH, Free T4, Free T3
- Also include a test for thyroid peroxidase or TPO antibodies (thyroid antibodies) if an autoimmune conditions are a concern. ie Hashimoto’s
- Work with a medical professional that recognizes the pitfalls of the traditional reference ranges many lab tests use.
- Don’t procrastinate! The longer you wait to get tested, the longer the symptoms will persist.
Keep in mind that the reference ranges for TSH is quite large with many labs interpreting a “normal” TSH at .5 to 5. Many people begin to feel the side effects of hypothyroid at a TSH of 2.5, also known as subclinical hypothyroid (3).