What Is Thyroid Disease?
What does your thyroid do?
Your thyroid gland influences almost all of the metabolic processes in your body through the hormones it produces. Your thyroid gland is part of your endocrine system. When your thyroid makes either too much or too little of important hormones, it’s called thyroid disease.
Thyroid disease and disorders can range from a small, harmless goiter (enlarged gland) that needs no treatment, to life-threatening cancer. The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism, while inadequate hormone production leads to hypothyroidism. Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.
Where is your thyroid located?
It's at the front of your neck, under your skin. Your thyroid is small and butterfly-shaped.
Thyroid Disease Types and Causes
There are two main types of thyroid disease: hyperthyroidism and hypothyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.
Hyperthyroidism vs. hypothyroidism
All types of hyperthyroidism are due to an overproduction of thyroid hormones, but the condition can occur in several ways:
- Graves' disease: The production of too much thyroid hormone.
- Toxic adenomas: Nodules that form in the thyroid gland and upset the body’s chemical balance by making thyroid hormones. Some goiters may contain several of these nodules.
- Subacute thyroiditis: Inflammation of the thyroid that causes the gland to “leak” excess hormones. This leads to temporary hyperthyroidism that generally lasts a few weeks but may persist for months.
- Pituitary gland malfunctions or cancerous growths in the thyroid gland: In rare cases, these can cause hyperthyroidism.
Hypothyroidism, by contrast, stems from an underproduction of thyroid hormones. As your body needs certain amounts of thyroid hormones to make energy, a drop in hormone production leads to lower energy levels. Causes of hypothyroidism include:
- Hashimoto's thyroiditis: In this autoimmune disorder, the body attacks thyroid tissue. The tissue eventually dies and stops producing hormones.
- Postpartum thyroiditis: This can happen anytime in the year after you give birth, or have a miscarriage or abortion. It's not common, occurring in 5% to 9% of those situations. It’s usually a temporary condition.
- Iodine deficiency: Iodine is used by the thyroid to produce hormones. An iodine deficiency is an issue that affects several million people around the world.
- Removal of your thyroid gland: Your thyroid may have been surgically removed or chemically destroyed.
- Exposure to excessive amounts of iodine: Cold and sinus medicines, the heart medicine amiodarone, or certain contrast dyes given before some X-rays may expose you to too much iodine.
- Past thyroid issues: You may be at greater risk for hypothyroidism if you have had thyroid problems in the past.
- Lithium: This drug is also linked to hypothyroidism.
Hypothyroidism poses a special danger to newborns and infants. A lack of thyroid hormones in the system at an early age can cause intellectual disability and dwarfism (stunted growth). Doctors now regularly check the thyroid levels of most babies soon after birth. If the levels are low, treatment starts right away. The causes of hypothyroidism in babies and adults are the same:
- A pituitary disorder
- A defective thyroid
- A missing thyroid gland
Cancer of the thyroid gland is rare and occurs in about 5% of thyroid nodules. You might have one or more thyroid nodules for several years before your doctor finds that they're cancerous. If you've had radiation treatment to your head and neck earlier in life, possibly as a remedy for acne, you may have a higher risk of getting thyroid cancer.
Risk Factors for Thyroid Problems
Anyone can have thyroid problems, and thyroid disease is common. Women are five to eight times more likely than men to be diagnosed with thyroid issues. You also have a higher risk for them if you:
- Have a family history of thyroid problems.
- Have pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome, or Turner syndrome.
- Take meds that have iodine.
- Are 60 or older.
- Had a previous thyroid condition or cancer (thyroidectomy or radiation).
Thyroid Disease Symptoms
Symptoms of hyperthyroidism include:
- irregular heartbeat
- weight loss
- protruding eyes
Symptoms of hypothyroidism include:
- weight gain
- abnormal bone development
- stunted growth
An infant with hypothyroidism may be inactive and quiet, have a poor appetite, and sleep for long periods.
Early signs of thyroid disease include changes in your:
- tolerance for hot or cold temps
- menstrual cycle
- energy level or mood
If you or your child have one or more of these symptoms, contact a doctor.
Weight gain in hypothyroidism isn't uncommon, but it's usually only 5 to 10 pounds. Large weight gain is rare and associated with severe hypothyroidism. If your only symptom is weight gain, you probably have something other than a thyroid problem.
How do thyroid problems affect your body?
Thyroid disorders can affect your heart rate, mood, energy level, metabolism, bone health, and pregnancy, along with many other body functions.
Thyroid Disease Diagnosis
Thyroid disease can be tricky to diagnose. That's because its symptoms can look like those of other conditions.
For example, thyroid disease symptoms could be similar to those you might have during pregnancy. These tests help your doctor know if you have a thyroid issue:
Blood tests. One of the surest ways to diagnose a thyroid problem, these tests measure the amount of thyroid hormones in your blood. They're done by taking blood from a vein in your arm.
Imaging tests. Looking at your thyroid might answer a lot of questions. Your doctor might do an imaging test called a thyroid scan. This lets them check the thyroid for an increased size, shape, or presence of growths (nodules).
They also might do an ultrasound. This transmits high-frequency sound waves, which you can't hear, through your body. Echoes are recorded and transformed into video or photographic images. It takes 20-30 minutes.
Physical exams. Done in your doctor's office, this is a simple and painless test where your doctor feels your neck for any growths or enlargement of the thyroid.
Iodine uptake tests. If you have hypothyroidism, your doctor might do this test to find what's causing it. This tracks the amount of iodine absorbed by your thyroid gland. You get iodine from the foods you eat. It's a key ingredient of thyroid hormone, so the amount of iodine your thyroid absorbs is a good way to tell how much hormone your gland is making.
How to check your thyroid at home
Get a mirror and a glass of water. Follow these steps:
- Locate your thyroid on the front of your neck, between your collarbone and Adam’s apple.
- Tip your head back while looking in a mirror.
- Take a drink of water while your head is tilted back. Watch your thyroid as you swallow.
- Look for lumps or bumps. You may be able to see them when you swallow the water.
Repeat this test a few times. If you see any lumps or bumps, contact your doctor.
Thyroid Disease Treatment
Your doctor can use different ways to restore your thyroid hormone levels to normal. Each treatment depends on the type and cause of your thyroid condition.
Subacute thyroiditis treatment
Although subacute thyroiditis can bring on temporary hyperthyroidism, this condition doesn't require medical treatment.
You can take acetaminophen or aspirin for any pain from the inflamed thyroid. (Children under age 19 shouldn't take aspirin because it's been linked to Reye's syndrome.) If over-the-counter drugs don't help, your doctor may prescribe anti-inflammatory drugs, such as dexamethasone or prednisone, for a short time.
Thyroid hormone production can be slowed or stopped completely with:
- Radioactive iodine treatment
- Antithyroid medication
If your doctor decides that radioactive treatment is best, you'll swallow a tablet or liquid with enough radioactive iodine to damage the cells of your thyroid gland so they can't make hormones. Sometimes you'll need more than one treatment to cut back hormone production to a normal level. Many people develop hypothyroidism as a result of this procedure.
After you start using antithyroid medications, your symptoms should begin to disappear in about 6-8 weeks. But you'll typically need to keep taking the medication for about a year. At that time, your doctor will check to see if you can stop. You'll need regular checkups once you're off the medicine to make sure your hormone levels stay balanced.
Doctors don't usually do surgery unless you're pregnant (and can’t take antithyroid medicine) or have a large goiter or cancerous nodule.
Someone with hypothyroidism will have to take thyroid hormone replacement for the rest of their life. No surgery, drugs, or complementary medicine can boost your thyroid once it slows down.
Doctors generally prescribe manmade forms of thyroid hormone, such as levothyroxine. Side effects are rare, but some people have nervousness or chest pain while taking these drugs. Adjusting the dose of medication usually gets rid of any unpleasant effects.
Let your doctor know about everything you're taking because some things could affect how well the medication works:
- Estrogen in hormone replacement therapy or birth control
- The blood-thinning drug warfarin
- The heart drug digitalis
- Supplements and products with magnesium, aluminum, iron, or soy
Thyroid cancer treatment
The first way to treat thyroid cancer is usually by removing either the cancerous tissue or the whole thyroid gland, a surgical procedure known as a thyroidectomy. If your cancer has spread, any other affected tissues, such as the lymph glands in your neck, will be removed, too.
Alternative Treatment for Thyroid Problems
You might try other therapies to cleanse your body, restore immune function, and balance your production and release of hormones. Talk to your doctor if you're interested in these other methods to make sure they won't harm you or interfere with your treatment.
A naturopath may use homeopathic mixtures, herbs, preparations based on traditional Chinese medicine (which links thyroid problems to emotional distress), and acupuncture to remove blocks to your “life force energy.” Naturopaths are authorized to treat thyroid disease in some states, but in others, it's illegal. While they may help with the stress associated with thyroid disease, there are no good studies showing that these therapies are effective for treating thyroid disorders.
Chiropractors use spinal manipulation to treat symptoms of thyroid disorders by easing muscle tension and improving blood circulation.
Protein, calcium, magnesium, and iodine help your thyroid work. Make sure you're getting plenty of all the B vitamins, vitamin A, and vitamin C. If you don't have enough iodine in your system, taking selenium can cause hypothyroidism.
Avoid these products:
- Pseudoephedrine (found in over-the-counter cold remedies) can cause nervousness, insomnia, headache, and high blood pressure.
- Alkaloids, including caffeine, morphine, and quinine, can raise your blood pressure and heart rate.
- Your thyroid gland, part of your endocrine system, influences almost all of the metabolic processes in your body.
- When your thyroid gland produces too little or too much of important hormones, it's called thyroid disease.
- There are two main types of thyroid disease: hyperthyroidism and hypothyroidism.
- Thyroid disease symptoms can mimic those of other conditions, sometimes making thyroid disease hard to diagnose.
- Treatment depends on your type and cause of thyroid disease.
Thyroid Problem FAQs
Is thyroid disease serious?
That depends. Thyroid problems can range from harmless goiters requiring no treatment to thyroid cancer, which can be life-threatening.
What happens if thyroid disease isn’t treated?
You can develop complications that range from mild to deadly.
Can an enlarged thyroid gland go back to normal on its own?
It's possible, but you may need treatment. If you have symptoms, see your doctor to make sure you get treatment if needed.