What Is The Thyroid?

  • The thyroid gland is a small organ that’s located in the front of the neck, wrapped around the windpipe (trachea). It’s shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat.
  • The thyroid is a gland. You have glands throughout your body, where they create and release substances that help your body do a specific thing.
  • Your thyroid makes hormones that help control many vital functions of your body.
  • When your thyroid doesn’t work properly, it can impact your entire body.
  • If your body makes too much thyroid hormone, you can develop a condition called hyperthyroidism.
  • If your body makes too little thyroid hormone, it’s called hypothyroidism.
  • Both conditions are serious and need to be treated by your healthcare provider.

What does the thyroid do?

  • Your thyroid releases and controls thyroid hormones that control metabolism.

Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your body’s systems working correctly. Think of your metabolism as a generator. It takes in raw energy and uses it to power something bigger.

  • The thyroid controls your metabolism with a few specific hormones — T4 (thyroxine, contains four iodide atoms) and T3 (triiodothyronine, contains three iodide atoms).

These two hormones are created by the thyroid and they tell the body’s cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.

This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream.

When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone.

This hormone is called thyroid stimulating hormone (TSH). The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.

What is thyroid disease?

  • Thyroid disease is a general term for a medical condition that keeps your thyroid from making the right amount of hormones.
  • Your thyroid typically makes hormones that keep your body functioning normally.
  • When the thyroid makes too much thyroid hormone, your body uses energy too quickly. This is called hyperthyroidism.
  • Using energy too quickly will do more than make you tired — it can make your heart beat faster, cause you to lose weight without trying and even make you feel nervous.
  • Your thyroid can also make too little thyroid hormone. This is called hypothyroidism. When you have too little thyroid hormone in your body, it can make you feel tired, you might gain weight and you may even be unable to tolerate cold temperatures.

These two main disorders can be caused by a variety of conditions. They can also be passed down through families (inherited).

Who is affected by thyroid disease?

  • Thyroid disease can affect anyone — men, women, infants, teenagers and the elderly. It can be present at birth (typically hypothyroidism) and it can develop as you age (often after menopause in women).
  • Thyroid disease is very common, with an estimated 20 million people in the Unites States having some type of thyroid disorder.
  • A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.

You may be at a higher risk of developing a thyroid disease if you:

  • Have a family history of thyroid disease.
  • Have a medical condition (these can include pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome).
  • Take a medication that’s high in iodine (amiodarone).
  • Are older than 60, especially in women.
  • Have had treatment for a past thyroid condition or cancer (thyroidectomy or radiation).

Symptoms And Causes Of Thyroid Disease

 

2. Hypothyroidism

On the opposite end of the spectrum, an under active thyroid which produces inadequate amounts of T3/T4 thyroid hormones is defined as hypothyroidism. Symptoms include tiredness, weight gain, cold intolerance, baldness, depression, dry skin/hair/nails, and irritability. Common causes include a thyroid deficiency from birth, Hashimoto’s thyroiditis, nutritional iodine deficiency, pituitary gland abnormality, metal toxicity, and imbalance of good vs. bad bacteria. The conventional approach is a synthetic hormone called Levothyroxine. With the exception of increasing exercise, the natural steps ­to reduce risk for hypothyroidism are exactly the same for hyperthyroidism. [3] Exercise may help boost thyroid hormones, providing support for a sluggish, under active gland.

What causes thyroid disease?

  • The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.

Conditions That Can Cause Hypothyroidism Include:

  • Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces.
  • Hashimoto’s thyroiditis: A painless disease, Hashimoto’s thyroiditis is an autoimmune condition where the body’s cells attack and damage the thyroid. This is an inherited condition.
  • Postpartum thyroiditis: This condition occurs in 5% to 9% of women after childbirth. 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..
  • A non-functioning thyroid gland: Sometimes, the thyroid gland doesn’t work correctly from birth. This affects about 1 in 4,000 newborns. If left untreated, the child could have both physical and mental issues in the future. All newborns are given a screening blood test in the hospital to check their thyroid function.

Conditions That Can Cause Hyperthyroidism Include:

  • Graves’ disease (Goiter): In this condition the entire thyroid gland might be overactive and produce too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland).
  • Nodules: Hyperthyroidism can be caused by nodules that are overactive within the thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while a gland with several nodules is called a toxic multi-nodular goiter.
  • Thyroiditis: This disorder can be either painful or not felt at all. In thyroiditis, the thyroid releases hormones that were stored there. This can last for a few weeks or months.
  • Excessive iodine: When you have too much iodine (the mineral that is used to make thyroid hormones) in your body, the thyroid makes more thyroid hormones than it needs. Excessive iodine can be found in some medications (amiodarone, a heart medication) and cough syrups.

Is There A Higher Risk Of Developing Thyroid Disease If I Have Diabetes?

  • If you have diabetes, you’re at a higher risk of developing a thyroid disease than people without diabetes.
  • Type 1 diabetes is an autoimmune disorder.
  • If you already have one autoimmune disorder, you are more likely to develop another one.
  • For people with type 2 diabetes, the risk is lower, but still there.
  • If you have type 2 diabetes, you’re more likely to develop a thyroid disease later in life.

Regular testing is recommended to check for thyroid issues. Those with type 1 diabetes may be tested more often — immediately after diagnosis and then every year or so — than people with type 2 diabetes. There isn’t a regular schedule for testing if you have type 2 diabetes, however your healthcare provider may suggest a schedule for testing over time.

If you have diabetes and get a positive thyroid test, there are a few things to you can do to help feel the best possible. These tips include:

  • Getting enough sleep.
  • Exercising regularly.
  • Watching your diet.
  • Taking all of your medications as directed.
  • Getting tested regularly as directed by your healthcare provider.

What Common Symptoms Can Happen With Thyroid Disease?

  • There are a variety of symptoms you could experience if you have a thyroid disease.
  • Unfortunately, symptoms of a thyroid condition are often very similar to the signs of other medical conditions and stages of life.
  • This can make it difficult to know if your symptoms are related to a thyroid issue or something else entirely.
  • Symptoms of thyroid disease can be divided into two groups — those related to having too much thyroid hormone (hyperthyroidism) and those related to having too little thyroid hormone (hypothyroidism).

Symptoms Of An Overactive Thyroid (Hyperthyroidism) Can Include:

  • Experiencing anxiety, irritability and nervousness.
  • Having trouble sleeping.
  • Losing weight.
  • Having an enlarged thyroid gland or a goiter.
  • Having muscle weakness and tremors.
  • Experiencing irregular menstrual periods or having your menstrual cycle stop.
  • Feeling sensitive to heat.
  • Having vision problems or eye irritation.

Symptoms Of An Under-active Thyroid (Hypothyroidism) Can Include:

  • Feeling tired (fatigue).
  • Gaining weight.
  • Experiencing forgetfulness.
  • Having frequent and heavy menstrual periods.
  • Having dry and coarse hair.
  • Having a hoarse voice.
  • Experiencing an intolerance to cold temperatures.

Can Thyroid Issues Make Me Lose My Hair?

  • Yes ,hair loss is a symptom of thyroid disease, particularly hypothyroidism.
  • If you start to experience hair loss and are concerned about it, talk to your healthcare provider.

Can Thyroid Issues Cause Seizures?

  • In most cases, thyroid issues don’t cause seizures.
  • However, if you have a very severe cases of hypothyroidism that hasn’t been diagnosed or treated, your risk of developing low serum sodium goes up. This could lead to seizures.

DIAGNOSIS AND TESTS

How to do a self-exam of your thyroid.-Video

How is thyroid disease diagnosed?

  • Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions.
  • You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease.
  • Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue.

These tests include:

  1. Blood tests.
  2. Imaging tests.
  3. Physical exams.

1.Blood tests

  • One of the most definitive ways to diagnose a thyroid problem is through blood tests.
  • Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood.
  • These tests are done by taking blood from a vein in your arm.

Thyroid blood tests are used to see if you have:

  • Hyperthyroidism.
  • Hypothyroidism.

Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:

  • Thyroiditis.
  • Graves’ disease.
  • Hashimoto’s disease.
  • Goiter.
  • Thyroid nodule.
  • Thyroid cancer.

The Specific Blood Tests That Will Be Done To Test Your Thyroid Can Include:

1. Thyroid-stimulating hormone (TSH)

  •  THS is produced in the pituitary gland and regulates the balance of thyroid hormones — including T4 and T3 — in the bloodstream.
  • This is usually the first test your provider will do to check for thyroid hormone imbalance.
  • Most of the time, thyroid hormone deficiency (hypothyroidism) is associated with an elevated TSH level, while thyroid hormone excess (hyperthyroidism) is associated with a low TSH level.
  • If TSH is abnormal, measurement of thyroid hormones directly, including thyroxine (T4) and triiodothyronine (T3) may be done to further evaluate the problem.
  • Normal TSH range for an adult: 0.40 – 4.50 mIU/mL (milli-international units per liter of blood).

2. T4: Thyroxine

  • Tests for hypothyroidism and hyperthyroidism, and used to monitor treatment of thyroid disorders.
  • Low T4 is seen with hypothyroidism, whereas high T4 levels may indicate hyperthyroidism. Normal T4 range for an adult: 5.0 – 11.0 ug/dL (micrograms per deciliter of blood).

3.Ft4: Free T4 Or Free Thyroxine

  • Method of measuring T4 that eliminates the effect of proteins that naturally bind T4 and may prevent accurate measurement.
  • Normal FT4 range for an adult: 0.9 – 1.7 ng/dL (nanograms per deciliter of blood)

4. T3: Triiodothyronine

  • Tests help diagnose hyperthyroidism or to show the severity of hyperthyroidism. Low T3 levels can be observed in hypothyroidism, but more often this test is useful in the diagnosis and management of hyperthyroidism, where T3 levels are elevated. Normal T3 range: 100 – 200 ng/dL (nanograms per deciliter of blood).

4.Ft3: Free T3 Or Free Triiodothyronine

  • Method of measuring T3 that eliminates the effect of proteins that naturally bind T3 and may prevent accurate measurement.
  • Normal FT3 range: 2.3 – 4.1 pg/mL (picograms per milliliter of blood)

These tests alone aren’t meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.

Additional blood tests might include:

5.Thyroid antibodies:

  • These tests help identify different types of autoimmune thyroid conditions.
  • Common thyroid antibody tests include
  • microsomal antibodies (also known as thyroid peroxidase antibodies or TPO antibodies),
  • thyroglobulin antibodies (also known as TG antibodies), and
  • thyroid receptor antibodies (includes thyroid stimulating immunoglobulins [TSI] and
  • thyroid blocking immunoglobulins [TBI]).

6.Calcitonin:

  • This test is used to diagnose C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.
  • Thyroglobulin: This test is used to diagnose thyroiditis (thyroid inflammation) and to monitor treatment of thyroid cancer.

Talk to your healthcare provider about the ranges for these thyroid blood tests. Your ranges might not be the same as someone else’s. That’s often alright. If you have any concerns or worries about your blood test results, talk to your provider.

2.Imaging Tests-/Thyroid Scan

  • Imaging test is called a thyroid scan.
  • This allows your provider to look at your thyroid to check for an increased size, shape or growths (nodules).
  • Your provider could also use an imaging test called an ultrasound.

This is a diagnostic procedure that transmits high-frequency sound waves, inaudible to the human ear, through body tissues. The echoes are recorded and transformed into video or photographic images. You may think of ultrasounds related to pregnancy, but they are used to diagnose many different issues within your body. Unlike X-rays, ultrasounds do not use radiation.

  • There’s typically little or no preparation before your ultrasound. You don’t need to change your diet beforehand or fast.
  • During the test, you’ll lie flat on a padded examining table with your head positioned on a pillow so that your head is tilted back.
  • A warm, water-soluble gel is applied to the skin over the area that’s being examined.
  • This gel won’t hurt your skin or stain your clothes.
  • Your healthcare provider will then apply a probe to your neck and gently move it around to see all parts of the thyroid.
  • An ultrasound typically takes about 20 to 30 minutes.

3.Physical exam

  • Another way to quickly check the thyroid is with a physical exam in your healthcare provider’s office.
  • This is a very simple and painless test where your provider feels your neck for any growths or enlargement of the thyroid.

Management And Treatment Of Thyroid Disease

How Is Thyroid Disease Treated?

Your healthcare provider’s goal is to return your thyroid hormone levels to normal. This can be done in a variety of ways and each specific treatment will depend on the cause of your thyroid condition.

Treatment Options For  High Levels Of Thyroid Hormones (Hyperthyroidism)

  • Anti-thyroid drugs (methimazole and propylthioracil): These are medications that stop your thyroid from making hormones.
  • Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
  • Beta blockers: These medications don’t change the amount of hormones in your body, but they help control your symptoms.
  • Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid (thyroidectomy). This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.

Treatment Options For Low Levels Of Thyroid Hormones (Hypothyroidism)

  • Natural approaches are numerous and often boil down to one thing: DIET.
  • Reducing gluten and dairy casein may help protect the thyroid gland in some individuals.

Reducing gluten and dairy casein may help protect the thyroid gland in some individuals. 

Gluten intolerance occurs when the body, specifically the digestive tract, responds to the presence of gluten in food

Gluten is a very hard protein found in wheat, barley, and rye products, and most individuals today are sensitive – if not downright intolerant – to its structure.

Gluten contains gliadin, a protein that is foreign to the human body-When the immune system attacks gliadin, the antibodies also attack the thyroid.An inactive or underproductive thyroid can interfere with proper hormone synthesis and metabolism, and it can also affect Weight And Energy.

  • If you have an autoimmune thyroid disorder (ATD), it is imperative that you completely avoid gluten. For those who suffer from a gluten sensitivity, avoiding gluten may be the best choice to protect your thyroid and overall health.
  • Many people who have chosen a gluten-free lifestyle either by need or by choice report incredible and even dramatic improvements in their health.
  • The best answer for all of us may be a gluten-free lifestyle, especially if we are seeking to balance hormone levels.
  • Instead of wheat, choose gluten-free whole grains like quinoa, buckwheat, and millet.
  • The use of probiotic bifidobacteria, specifically, appears especially promising as a long term option for patients with celiac disease.

 

 

  • Nascent iodine, lithium orotate, probiotics, vitamin D3, omega­-3 fats, L­-dopa (mucuna pruriens), and L-tyrosine are supplements that can help support thyroid health.
  • Getting enough sleep,
  • deep breathing meditation, and general relaxation may also be helpful for reducing thyroid stress.
  • Thyroid replacement medication: This drug is a synthetic (man-made) way to add thyroid hormones back into your body.
  • One drug that’s commonly used is called levothyroxine.
  • By using a medication, you can control thyroid disease and live a normal life.

 

How to Check Your Thyroid At Home

You can do a quick and easy self-exam of your thyroid at home. The only tools you need to do this self-exam are a mirror and a glass of water.

Steps For The Thyroid Self-Exam

  1. Start by identifying where your thyroid is located.
  2. Generally, you’ll find the thyroid on the front of your neck, between your collar bone and Adam’s apple.
  3. In men, the Adam’s apple is much easier to see.
  4. For women, it’s usually easiest to look from the collar bone up.
  5. Tip your head back while looking in a mirror.
  6. Look at your neck and try to hone in on the space you will be looking once you start the exam.
  7. Once you’re ready, take a drink of water while your head is tilted back.
  8. Watch your thyroid as you swallow.
  9. During this test, you’re looking for lumps or bumps.
  10. You may be able to see them when you swallow the water.

Repeat this test a few times to get a good look at your thyroid. If you see any lumps or bumps, reach out to your healthcare provider.

Should I Exercise If I Have A Thyroid Disease?

  • Regular exercise is an important part of a healthy lifestyle.
  • You do not need to change your exercise routine if you have a thyroid disease.
  • Exercise does not drain your body’s thyroid hormones and it shouldn’t hurt you to exercise.
  • It is important to talk to your Doc and PT  before you start a new exercise routine to make sure that it’s a good fit for you.

Can I Live A Normal Life With A Thyroid Disease?

  • Yes you can usually live a normal life with a thyroid disease.
  • It may take some time to find the right treatment option for you and control your hormone levels, but then people with these types of conditions can usually live life without many restrictions.

References

  • American Thyroid Association. What you need to know about the thyroid. (http://www.thyroid.org/thyroid-information/) Accessed 11/18/2021.
  • US Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. Hyperthyroidism (Overactive Thyroid). (https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism?dkrd=hispt0298) Accessed 11/18/2021.
  • American Thyroid Association. General Information/Press Room. (https://www.thyroid.org/media-main/press-room/) Accessed 11/18/2021.
  • US Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases. Hypothyroidism (Underactive Thyroid). (https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism) Accessed 11/18/2021.