The thyroid is a small butterfly-shaped gland located at the base of your neck that helps regulate your body’s systems, including your metabolism.
Clinically, thyroid problems typically fall into two categories: hormonal (hyperthyroidism or an overproduction of the hormone and hypothyroidism or an underproduction of the hormone) and structural (thyroid nodules and cancer). The good news is most issues can be managed once they are diagnosed and a treatment plan is put into place.
As an endocrinologist, I see patients with thyroid issues daily. Here are the five things we want you to know about this important but often misunderstood gland:
Age, Gender and Genetics Matter
When it comes to thyroid hormonal problems (hyperthyroidism or hypothyroidism) it’s more common in women and it’s more common as you age. Additionally, thyroid hormonal problems do often run in families.
Lack of Energy and Weight Gain Doesn’t Always Mean a Thyroid Problem
Thyroid problems can exhibit many frustrating symptoms that can range from a fast heart beat to weight gain and anxiety. It is important to work closely with your doctor to determine whether these symptoms are related to your thyroid or if there is another underlying cause. I spend a lot of time educating patients that if their thyroid hormone blood test results are in the normal range but their symptoms have not improved, it’s likely not their thyroid gland that is causing their symptoms. Instead they need to look at other possible causes like stress, bad eating habits, lack of exercise or other medical conditions such as obstructive sleep apnea or anemia. Symptoms of fatigue, weight gain, and memory problems are debilitating and frustrating to live with, but if the hormone tests are normal, often these symptoms stem from something else.
Most Thyroid Nodules are Not Cancerous
Many people have thyroid nodules and a vast majority (90 - 95 percent) are not cancerous. Thyroid cancer does not usually cause many symptoms and the most common first sign is a lump or swelling in the neck. If there is a concerning thyroid nodule, a doctor will take a biopsy (a simple procedure with a small needle) to determine whether there is cancer. Once it is diagnosed, thyroid cancer is treated with surgery and potentially with additional treatments based on the surgery results. Patients with thyroid cancer will need ongoing monitoring and treatment from an endocrinologist. Fortunately, most people diagnosed with thyroid cancer do very well because the treatments are effective.
Diagnosing and Managing Hyperthyroidism or Hypothyroidism Can be Straightforward
As I mentioned previously, the challenge with thyroid problems is that the symptoms can mimic other health conditions. It is important to work with your doctor to review your health history to weed out other potential problems as well as considering your thyroid gland. If it is determined your thyroid gland may be a problem, your doctor may give you a physical exam to check your thyroid gland and order an additional simple non-fasting test to measure the TSH (Thyroid Stimulating Hormone) blood levels. For most people in most situations, measuring TSH can be a very accurate assessment of thyroid hormone problems. We can see some mild TSH fluctuations over the day and with time but those usually fall within a range. If you are diagnosed with a thyroid hormonal condition that is stable, you may only need a blood test once a year and a stable amount of medication. If the thyroid disease is more active, than more frequent monitoring may be needed.
When in Doubt, Talk To Your DoctorYou know your body best. If you are having troubling symptoms, do not hesitate to see your primary care provider. A majority of thyroid problems can be treated by your primary care doctor and they can refer you to an endocrinologist if additional specialized care is needed.