The thyroid gland controls many hormones related to metabolism within the human body.
It creates thyroxine and triiodothyronine, which tell each cell in the body how much energy to use. When something goes wrong with the thyroid, the body may use energy too quickly — called hyperthyroidism — or too slowly — called hypothyroidism.
Here’s what people need to know about thyroid disease, how it’s diagnosed and what treatment options are available. It’s better to have a diagnosis and seek help rather than suffer in silence. These conditions don’t just go away on their own.
Thyroid disease can be broken down into two primary categories — hyperthyroidism and hypothyroidism. Hyperthyroidism occurs when the thyroid produces too much thyroxine, a hormone that controls the body’s metabolism. Cells start burning too much energy when there’s a surplus. This condition can result in fatigue, unintended weight loss or problems with a rapid heartbeat. Patients may also experience:
Anxiety and irritability
An enlarged thyroid gland
There are also rare symptoms in some patients called Graves’ ophthalmopathy. This condition causes the tissue behind the eyes to swell, forcing the eyes to bulge beyond their intended orbits. If left untreated, this can cause discomfort as well as vision problems.
Several conditions can cause hyperthyroidism, including:
Too much iodine: The body uses iodine to make thyroid hormones. The thyroid can go into overdrive if there’s too much.
Thyroiditis: This is an inflammation in the thyroid gland.
Nodules: Individual nodules within the thyroid gland can become overactive, producing too much hormone.
Graves’ disease: This condition causes the entire thyroid gland to be perpetually overactive.
On the opposite side of the coin is hypothyroidism or underactive thyroid disease. Instead of producing too much hormone, the thyroid doesn’t have enough hormone. The symptoms of this disease are a mirror image of hyperthyroidism and often include:
Low body temperature
Weight gain or inability to lose weight
Dry or coarse skin
Low hormone levels can cause a condition known as myxedema. Symptoms include confusion, coma and even heart failure.
Various conditions can cause hypothyroidism, including:
Iodine deficiency: Iodine is a necessary component used by the body to produce thyroid hormones. Without it, the thyroid can’t function properly.
Thyroiditis: This is an inflammation in the thyroid gland.
Hashimoto’s Thyroiditis: This autoimmune condition causes the body’s immune system to attack the thyroid gland.
Postpartum Thyroiditis: Inflammation can occur after pregnancy. It’s usually temporary.
Around one out of every 4,000 people is born without a functioning thyroid that requires treatment from birth. If the condition is not treated, it can cause various health problems throughout someone’s life.
The thyroid gland is often prone to developing various types of growths. Most of these are benign or harmless, but some can become malignant or cancerous.
The thyroid gland usually contains two types of cells — follicular cells that create the thyroid hormones and c-cells that produce calcitonin. The latter hormone tells the body what to do with calcium. Sometimes the gland will also contain lymphocytes that are part of the immune system and stromal cells that support other bodily functions. Each of these cells can develop a different type of cancer.
Thankfully, most thyroid cancers are papillary, which means they grow very slowly but are very treatable. Even if they spread to the lymph nodes, they rarely are fatal. Another form of thyroid cancer is follicular, which makes up around one out of 10 cases and is more common when iodine deficiencies are present.
These are the most common causes of thyroid disease, but it isn’t an exhaustive list. Who is at risk for thyroid disease? About one in 20 people have a thyroid disorder, and women are more likely to receive a diagnosis than men.
In addition to gender, other risk factors include:
Age. People over 60 are at higher risk for thyroid disease.
Preexisting conditions. Autoimmune disorders such as type 1 diabetes, lupus, rheumatoid arthritis or celiac disease increase the risk.
Problems with the pituitary gland
Using iodine contrast
Damage or trauma to the thyroid gland
People can develop thyroid disease without any of these criteria. These factors mean a patient may be more likely to have issues at some point in their life.
Detecting a thyroid disease often involves a physical exam and blood and imaging tests. Blood tests are the most effective and definitive way to diagnose a thyroid condition. Doctors will use blood samples to test for:
Thyroid-stimulating hormones (TSH)
Thyroid peroxidase (TPO) antibodies
These blood tests can determine if the thyroid is functioning correctly. Testing for these thyroid-stimulating hormones can also determine if a pituitary condition might be the underlying cause creating the thyroid disease. That makes the treatment plan clearer and more likely to be successful.
Treating thyroid disease depends on the underlying cause preventing the gland from functioning correctly and whether it’s overactive or underactive. Doctors may wish to begin by treating what’s causing the issue and waiting to see if it will correct itself over time.
Patients with hyperthyroidism will need to take medication that suppresses thyroid function, so it stops producing hormones so quickly. Hormone replacement therapy is an option for people with hypothyroidism.
Thyroid cancer treatment is similar to other forms of cancer. Depending on each patient's diagnosis, the plan may include surgery, radiation therapy, hormone therapy, chemotherapy or targeted drug therapy.
The thyroid gland and its functions are essential for a healthy life. Unfortunately, the human form isn’t perfect, and sometimes things go wrong. Thankfully, there are treatment options for nearly every thyroid disease or related condition. Most are easy to detect with some simple blood tests. People who suspect they may have thyroid disease should bring this up with their doctors and request testing so they can feel better sooner.