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The Thyroid: A Small Gland, A Big Job

Did you know January is Thyroid Awareness Month? The signs and symptoms of a sluggish or too-fast thyroid gland can be vague: moodiness, nervousness, fatigue, constipation, and hair loss.

Published: Feb 25, 2014

The Thyroid: A Small Gland, A Big Job

The thyroid is a small gland, shaped similar to a butterfly. It's small enough to sit in just the lower portion of the neck, but the job it does for the body is huge. So when the thyroid gland is malfunctioning, the results on a person's health can be devastating. 

The thyroid gland's job is to produce and secrete certain hormones. These include: triiodothyronine, also known as T3, and thyroxine, also known as T4. By secreting these hormones, which tell the body's cells how much energy to use, the thyroid gland controls a person's metabolism--or the rate at which cells perform their individual functions. In other words, it controls how a person's body turns food into energy.

If all is functioning normally, the thyroid will produce just the right amount of hormones needed to maintain the metabolism at its proper rate. The thyroid will naturally create replacement hormones for the ones used. This occurs when the pituitary gland--located in the center of the skull below the brain--senses an imbalance and sends its own hormone as a signal to the thyroid gland.

This natural process can go awry in two ways: 

  • The thyroid produces too much hormone and the body uses energy faster than it should, which is known as hyperthyroidism.
  • The thyroid produces too little hormone and the body uses energy slower than it should, which is known as hypothyroidism

According to information on ClevelandClinic.org, thyroid disease occurs for a number of reasons, and people of all races and ages can develop thyroid disease. However, the incidence of thyroid disease increases with age. An estimated 20% of women over the age of 60 have some form of thyroid disease. Hypothyroidism is much more common in the elderly population, and symptoms may be non-specific compared to symptoms in the younger population.

What is hypothyroidism and what causes it?

The most common cause in the U.S. is called Hashimoto's thyroiditis, which causes the immune system to attack its own thyroid tissue. This type of illness is also known as an autoimmune disorder. When it occurs the thyroid gland can't make enough hormones. The resulting symptoms can include:

  • fatigue and weakness
  • dry skin
  • brittle nails
  • hair loss
  • constipation
  • heavy or irregular periods

Some people develop this type of thyroid disorder after surgery and/or radiation therapy for cancer. Less common causes are viral infections and some medications.

Hypothyroidism can also cause one to get cold easily, as well as memory problems or trouble thinking clearly. Ultimately, if untreated, this condition of the thyroid can lead to higher cholesterol, increasing the chances of a heart attack or stroke. Hypothyroidism can develop slowly and over time making it easy to not notice symptoms, or attribute the symptoms to aging, stress, or other conditions.

What is hyperthyroidism and what causes it?

A condition known as Graves' disease can be a primary cause of most incidents of hyperthyroidism causing the body to "speed up." Individuals with hyperthyroidism may feel nervous all the time, lose weight quickly, perspire a great deal, and have a rapid heartbeat. Like Hashimoto's, Graves' is an autoimmune illness and can cause the thyroid to enlarge greatly. Other symptoms of a hyperactive thyroid include:

  • moodiness
  • shaky hands or trouble breathing
  • warm, red or itchy skin
  • bulging or more prominent eyes
  • *muscle or joint pain
  • neck discomfort or enlargement

At its worst, this condition can lead to serious heart problems, bone problems and a dangerous medical condition called thyroid storm when the symptoms become heightened to extraordinary levels. This is a potentially life-threatening condition that requires emergency treatment.

People can have hyperthyroidism and not know it. Many may be asymptomatic, or the symptoms are often misinterpreted for other disorders. In fact, sometimes thyroid disorders are discovered when a physician is testing for a different condition entirely.

How are these two conditions treated?

Doctors use blood testing and/or imaging tests to determine if an individual has one of these conditions. Fortunately, both hyper- and hypothyroidism can be treated successfully. Hyperthyroidism is often treated by radioactive iodine and anti-thyroid medicine, or sometimes surgery. Hypothyroidism is most often treated with routine medication. 

Other conditions of the thyroid

Less common problems associated with the thyroid gland include goiter and thyroid nodules. 

Goiter: This is a condition whereby the thyroid gland grows larger than normal. Although typically painless, a goiter can cause a cough or make it hard to breathe. This condition can be caused by a lack of iodine in one's diet, but in the U.S. it's typically the result of an under- or over-production of hormones, or nodules that develop on the thyroid gland itself. Treatment varies, but often--if a goiter poses no bothersome symptoms--it might not be treated at all.

Thyroid Nodules: These are lumps, abnormal masses or cysts on the thyroid. If they get large enough, these masses can cause breathing problems. At that point, they can be drained, or might need surgery to be fully removed. If they are malignant, more aggressive treatment is necessary.

Men get thyroid diseases, too

Though thyroid disorders tend to affect women more often than men, it's easy to forget that men can also develop thyroid disorders. However, the symptoms are different. Men don't typically suffer complete exhaustion like women might, nor do they commonly have chills or dry skin. Men are more likely to experience a more moderate tiredness as well as sexual performance problems, in addition to, or instead of, more common symptoms such as fatigue and moodiness. 

Because so many symptoms of thyroid disorders are ambiguous, such as irritability, weight gain and nervousness, doctors will likely want to test patients routinely for these conditions, and definitely at certain age milestones. 

Finally, conditions of the thyroid carry a genetic component so it is important that doctors are aware if a family member has been diagnosed with any type of thyroid disease.

REFERENCES:
Hyperthyroidism. (n.d.). Retrieved December 15, 2013, from webmd.com/a-to-z-guides/hyperthyroidism-topic-overview
Mayo Clinic Staff (n.d.). Hypothyroidism (underactive thyroid). Retrieved December 15, 2013, from mayoclinic.com/health/hypothyroidism/DS00353
Nippoldt, M.D., Todd B. Thyroid Disease: Can it affect a person's mood?. (n.d.). Retrieved December 15, 2013, from mayoclinic.com/health/thyroid-disease/AN00986
Shomon, Mary. (2011, October 3). Thyroid Testing and Diagnosis. Retrieved December 15, 2013, from thyroid.about.com/od/gettestedanddiagnosed/a/testdiagnose.htm
Symptoms of Thyroid Disorders. (n.d.). Retrieved December 15, 2013, from rightdiagnosis.com/t/thyroid/symptoms.htm
Understanding Thyroid Problems--the Basics. (n.d.). Retrieved December 15, 2013, from women.webmd.com/guide/understanding-thyroid-problems-basics

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