Common Thyroid Issues

Thyroid issues are more common than you may realize. Celebrities, politicians and even Olympic athletes are counted among the estimated 20 million Americans living with a thyroid condition.

Thyroid diseases are chronic diseases that shouldn’t be ignored.

Aristea Sideri Gugger, MD, PhD, a fellowship-trained endocrinologist with Atlantic Health System, explains the importance of a well-functioning thyroid and describes the seven most common thyroid conditions.

What is the thyroid and what is it important?

Your thyroid is a small, butterfly-shaped gland that sits at the bottom of your neck, just below the center of your throat. It produces hormones that control your metabolism (how fast you use calories from food for energy), body temperature and heart rate, among other things.

Your thyroid may be small, but it’s mighty. A well-functioning thyroid helps everything in your body work well — from your weight and bone structure to your heart and brain.

“Your thyroid doesn’t do just one thing,” says Dr. Sideri. “It influences nearly every function in your body.”

Common thyroid problems

Thyroid disease is a general term used to describe any dysfunction of the thyroid gland. While men can experience thyroid problems, it’s more common for women. According to the American Thyroid Association, one in eight women will develop a thyroid condition during her lifetime.

There are several types of thyroid conditions, some more common than others. Here are the top seven:

Hypothyroidism

The most common thyroid condition is hypothyroidism. With hypothyroidism, also called underactive thyroid, your gland doesn’t make enough of its hormones to function properly.

As Dr. Sideri explains it, “Your body is like a car. If the engine is on but you don’t push down enough on the gas pedal, the car is sluggish. The same is true when your thyroid doesn’t produce enough hormone. Everything slows down.”

Common symptoms of hypothyroidism may include:

• Constipation
• Extreme fatigue
• Feeling cold
• Irregular periods
• Low mood or depression
• Memory and concentration issues (brain fog)
• Nail and hair changes
• Slower heart rate
• Unexplained weight gain

Hashimoto’s disease

According to Dr. Sideri, the majority of hypothyroidism is caused by Hashimoto’s disease. Hashimoto’s is an autoimmune condition, meaning your body’s immune system mistakenly attacks your thyroid, slowly destroying it over time.

Signs of Hashimoto’s disease mirror those of hypothyroidism.

Hyperthyroidism

The opposite of hypothyroidism is hyperthyroidism. Here, your thyroid is overactive, producing too much of its hormones, speeding everything up.

Using Dr. Sideri’s car engine analogy, hyperthyroidism is “like pushing down on the gas pedal too much.”

Common symptoms of hyperthyroidism may include:

• Anxiety
• Changes to menstrual cycle
• Diarrhea
• Heart palpitations or fast heartbeat
• Increased sweating
• Tremors
• Trouble sleeping
• Unintentional weight loss

Some hair loss may also occur.

Graves’ disease

Like Hashimoto’s, Graves’ disease is an autoimmune condition where your immune system mistakenly attacks your thyroid — but it has the opposite effect. With Graves’, your body’s immune system tricks your thyroid into making too much of its hormones.

Graves’ disease isn’t as common as Hashimoto’s disease, and Dr. Sideri says the road from hyperthyroidism to Graves’ isn’t as clear as the road from hypothyroidism to Hashimoto’s.

“The only way to determine the etiology (cause) of a person’s hyperthyroidism (Graves’, toxic nodules or subacute/temporary thyroiditis) is to test.”

Symptoms of Graves’ mirror those of hyperthyroidism, and may include other complications such as swollen, irritated eyes known as thyroid eye disease (TED).

Thyroid nodules

Nodules are solid, fluid-filled or a mix of both “lumps and bumps” that grow inside the thyroid. They are common in people with Hashimoto’s disease and those over the age of 60. Most are benign (noncancerous) and painless.

Most nodules don’t cause symptoms and may not even be visible. However, if you notice any new growths that you can feel, or if you’re having a hard time swallowing or feel like something is stuck in your throat, it’s a good idea to have it checked out.

Dr. Sideri advises that all nodules be evaluated with ultrasound (the gold standard of care) and, if necessary, a biopsy (tissue sample) to rule out thyroid cancer.

Goiter (enlarged thyroid)

Goiter means enlarged thyroid. It can be genetic or the result of multiple nodules. Like nodules, a goiter doesn’t always cause symptoms and it may not even be noticeable. However, it can present as an enlarged neck. Pain is rare, but you may experience mild to severe throat compression, like something is stuck in your windpipe.

Thyroid cancer

Luckily, most thyroid growths are noncancerous. And for those that are malignant, the survival rate is extremely high.

“The vast majority of thyroid cancers progress slowly, taking a benign course,” says Dr. Sideri. “We can usually treat it successfully by surgically removing the thyroid gland.”

When to see a doctor

Dr. Sideri is quick to point out that all symptoms may not be caused by a thyroid condition, but it’s best to have a doctor make that determination.

A good rule of thumb, according to Dr. Sideri, is to have a medical evaluation any time you notice a new lump in your throat or experience new symptoms — especially a change in bowel habits, extreme fatigue, tremors, or rapid weight gain or loss.

“If you’re pregnant and have a known thyroid condition, it’s also very important to tell your doctor,” reminds Dr. Sideri.

If left untreated, thyroid disease — especially hypo- and hyperthyroidism — can lead to a cascade of health problems, including osteoporosis (bone loss), heart failure, stroke and even death.

Thyroid diseases are chronic diseases. They won’t just go away. If left untreated, they can lead to serious health problems, so don’t ignore the signs.