The thyroid gland is a small, butterfly-shaped organ located at the base of the neck, in front of the windpipe. It is the ‘master controller’ of metabolism and plays a key role in our health and wellbeing.3 It makes, stores and releases thyroid hormones into the blood, thus regulating metabolism. These hormones are essential for the proper functioning of all bodily tissues and organs. They enable our body to use its stores of energy efficiently, thereby controlling temperature and allowing our muscles to work properly.4
There are two dysfunctions of the thyroid gland:
Am I at risk?
Thyroid dysfunction is very common throughout the world, especially in women. Why women are more at risk than men is not fully understood, but they are not only more likely to have thyroid problems, but also develop them earlier in life.5 Certain times in a woman’s life make her more vulnerable to thyroid problems. They include:4
- During puberty and first menstruation
- During pregnancy
- Within the first six months after giving birth
- During the menopause
Did you know?
Problems of the thyroid gland are eight times more common in women than in men6
Regardless of your gender, you are at risk of thyroid dysfunctions if you:4
- Have a family history of thyroid problems
- Have an autoimmune disease such as type 1 diabetes
- Are over the age of 50
- Have had thyroid surgery
- Have Down’s or Turner’s syndrome
People who have had radiation treatments or whose necks have been exposed to x-rays are also more likely to suffer from thyroid problems.7 Interestingly white and Asian people are three times more at risk if compared to other populations.4
Hypothyroidism, or an underactive thyroid, is a common condition.8 It is caused when the thyroid gland does not produce enough thyroid hormones. This under-production of hormones slows down the body’s metabolism, often leaving patients feeling cold, tired and depressed.9 If you suffer from hypothyroidism you are also likely to notice you have gained weight4, despite following a sensible diet and taking regular exercise.9
Knowing the common symptoms:4,7,9,10
- Fatigue / drowsiness
- Cold intolerance
- Weight gain or increased difficultly losing weight (despite sensible diet and exercise)
- Abnormal menstrual periods and / or fertility problems
- Joint or muscle pain
- Thin and brittle hair or fingernails and / or dry flaky skin
- Puffy face, hands and feet
- Decreased libido
The symptoms of hypothyroidism are unpleasant and can affect a person’s self-esteem, work, home and family life. However, hypothyroidism does not just diminish quality of life, if left untreated it can cause more serious complications and become potentially life threatening.
Severe complications of hypothyroidism include:
- A heart rate so slow that it can cause patients to slip into a coma7
- Higher blood pressure and elevated cholesterol levels (significant risk factors of heart disease)11
- Alzheimer’s disease (increased risk in women)12
As there is no cure for hypothyroidism, the aim of the treatment is to replace the missing thyroid hormone in the body. Taken daily, levothyroxine (synthetically produced thyroid hormone) is the treatment of choice and should enable patients to live symptom free lives.4
If you have been diagnosed with hypothyroidism, it is important to remember that treatment is a life-long commitment and medication has to be taken every day even when symptoms are under control.4 This may seem a bit daunting, but by taking control of your condition and complying with your medication you should be able to remain symptom free.4 It is advisable to see your doctor more frequently if any changes in your condition occur.
Hyperthyroidism, or an overactive thyroid, is when the gland releases too much thyroid hormone in the blood speeding up the body’s metabolism.13 Hyperthyroidism tends to run in families, occurring most commonly in young women. Worryingly, little is known about why specific individuals get this condition.13
Knowing the common symptoms:13,14
- Weight loss (even when eating normally)
- Anxiety and irritability
- Very fast heart rate (often more than 100 beats per minute)
- Prominent, staring eyes
- Trembling hands
- Hair loss
- Frequent bowel movements
- Fast growing fingernails
- Thin and very smooth skin
- Sweating more than usual
- Abnormal menstrual periods
It is important that symptoms of hyperthyroidism are not left untreated as serious complications can occur. Untreated disease may lead to cardiac arrhythmia (an irregular rate of muscle contractions in the heart) through to heart attacks.14 Additionally, in women who have gone through the menopause, hyperthyroidism increases the risk of osteoporosis (a loss of bone mass) and potentially fatal fractures.14
A focus on… hyperthyroidism in pregnancy
Hyperthyroidism is particularly dangerous in pregnancy but luckily it is rare, however if left untreated can be serious for both mother and baby.15 Problems can include miscarriage, poor growth of the baby in the womb, premature labour and delivery, high blood pressure,6 physical defects in the baby, and ‘thyroid storm’ where a stressful event or massive infection can cause a dangerous rise in thyroid hormone levels.6
Hyperthyroidism in pregnancy is difficult to diagnose because many of the normal changes during pregnancy are similar to symptoms of the thyroid dysfunction, for example, feeling hot, excessive sweating, vomiting or a racing heartbeat.
If you are pregnant and have a heartbeat above 100 beats per minute plus are losing weight, you should see your doctor immediately to rule out hyperthyroidism.
The treatment of hyperthyroidism is more complex and no single treatment can treat all patients. A doctor’s treatment choice will be influenced by type and severity of the condition, age and possibly the patient’s other medical conditions.13
Treatment may involve antithyroid drugs which block the gland’s ability to make new thyroid hormones – some patients additionally receive levothyroxine, in order to compensate for the decreased hormone production. Alternatively, radioactive iodine therapy maybe used to destroy thyroid cells or surgery can be undertaken to partially remove the thyroid gland — these treatments are likely to cause hypothyroidism, however this is an easier condition to manage.13
Read different real life experiences of living with thyroid dysfunction.
DIAGNOSING THYROID DYSFUNCTION
Many patients remain undiagnosed with thyroid problems and suffer for a long time as their symptoms have been confused with other conditions, such as depression, obesity or the menopause. Thyroid dysfunction can be confirmed by your doctor through a simple blood test to check the level of thyroid stimulating hormone (TSH) and thyroid hormones in your blood.4
Treatment for thyroid dysfunction is straight forward, well-established and highly effective.
If you are concerned that you could be suffering from problems with your thyroid gland, please discuss this with your doctor. To aid your consultation download our Wellbeing Diary to help you keep a check of the symptoms you are experiencing, or try our short thyroid disorders Symptoms Checklist.
Did you know?
Up to 300 million people worldwide experience problems with their thyroid gland1, although over half are presumed to be unaware of their condition?2
- 1Khan A, Muzaffar M, Khan A et al. Thyroid Disorders, Etiology and Prevalence. J Med Sci. 2002;2:89-94.
- 2Canaris GJ, Manowitz NR, Mayor G et al. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160:526-34.
- 3American Thyroid Association. Thyroid Function Tests. 2005 Accessed March 2009.
- 4American Thyroid Association. ATA Hypothyroidism Booklet. Falls Church, VA 2003.
- 5Helfand M, Redfern CC. Clinical guideline, part 2. Screening for thyroid disease: an update. American College of Physicians. Ann Intern Med. 1998;129:144-58.
- 6ACOG Education Pamphlet AP128 – Thyroid Disease. American College of Obstetricians and Gynaecologists. Washington, DC. 2002.
- 7Roberts CG, Ladenson PW. Hypothyroidism. Lancet. 2004;363:793-803.
- 8Tunbridge WMG, Evered DC, Hall R et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endo. 1997;7:481-493.
- 9American Thyroid Association. Hypothyroidism. 2005. Accessed March 2009.
- 10Poppe K, Velkeniers B, Glinoer D; Medscape. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab. 2008;4:394-405.
- 11Rodondi N, Aujesky D, Vittinghoff E et al. Subclinical hypothyroidism and the risk of coronary heart disease: a meta-analysis. Am J Med. 2006;119:541-51.
- 12Tan ZS, Beiser A, Vasan RS et al. Thyroid function and the risk of Alzheimer disease: the Framingham Study. Arch Intern Med. 2008;168:1514-20.
- 13American Thyroid Association. Hyperthyroidism. 2005. Accessed March 2009.
- 14American Association of Clinical Endocrinologists. Hyperthyroidism. 2006. Accessed March 2009.
- 15De Groot LJ, Stagnaro-Green A, Vigersky R. Patient guide to the management of maternal hyperthyroidism before, during and after pregnancy. The Hormone Foundation. J Clin Endocrinol Metab 2007;92:0.