January is National Thyroid Awareness Month, and according to the American Thyroid Association, more than 20 million Americans have a form of thyroid disease. As we continue to explore goals for health and wellness in the new year, this post will highlight the importance of thyroid health and management, as well as debunk common myths about thyroid-related diseases.
We turned to two physicians to help. Tarandeep Kaur, MD, an endocrinologist with Dignity Health Medical Group — Stockton, and Patrick Richards, MD, an endocrinologist with Dignity Health Mercy Medical Group, share insights on managing thyroid health and thyroid disease treatment options.
Understanding the Thyroid
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, heartbeat and body temperature.
Thyroid problems typically fall into two categories: functional and structural. Functional diseases are caused by an overproduction or underproduction of the thyroid hormone (TH). Structural diseases stem from malignant (cancerous) and benign (non-cancerous) tumors and nodules, and diffuse goiter, which is an enlargement of the thyroid gland.
Types of Thyroid Diseases
Functional Thyroid Diseases
The two most common functional thyroid diseases are hypothyroidism and hyperthyroidism. Hypothyroidism is when a thyroid is sluggish and may not produce enough TH. Conversely, hyperthyroidism is when the thyroid is overly active and produces too much TH. Many things can cause the thyroid to go haywire, including genetics, pregnancy or an autoimmune disease — but it can be managed under the care of your physician once diagnosed.
Additionally, inflammation of the thyroid, or thyroiditis, can cause both hyperthyroidism and hypothyroidism. The inflammation initially triggers an overactive thyroid and leak of TH and over time, which can impair production of TH altogether.
Structural Thyroid Diseases
Thyroid cancer is a structural thyroid disease where malignant cells form in the thyroid. Thyroid cancer can be a result of genetic or environmental factors, and show no symptoms. Fortunately, it is a treatable type of cancer if diagnosed early.
Tarandeep Kaur, MD
Understanding Risks, Signs & Symptoms
There are a few things you can do to reduce risk of developing thyroid issues. This includes eating a healthy diet and reducing exposure to radiation. While anyone can develop a thyroid disease, Dr. Kaur shares that it’s much more common in women, especially as they age. There is an even greater risk if one has a family history of thyroid nodules or thyroid cancer.
Some of the more common symptoms associated with thyroid problems include:
That said, PCPs (primary care physicians) perform regular screenings for thyroid diseases and these issues can be diagnosed through blood work and tests such as the thyroid stimulating hormone (TSH) and Free T4 (Thyroxine) tests.
- Increased heart rate
- Consistent fatigue
- Weight gain
- Dry skin
- Changes in bowel movements and menstruation
Debunking Common Misconceptions
While the above symptoms could point to a thyroid disease diagnosis, it’s also important to understand that there could be a number of other factors for why patients may be experiencing symptoms — such as weight gain or fatigue — that are not related to thyroid disease. Your PCP can help you determine if your symptoms are related to thyroid disease and the best course of action.
Another common misconception is that thyroid disease is a result of iodine deficiency. Iodine helps create the thyroid hormone in the body and having a deficiency is possible, but iodine deficiencies are rare in the U.S. because of the sufficient levels of the mineral in our food supply.
It is also important to note that 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 display 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. The good news is that the treatments for thyroid cancer are highly effective.
Dr. Richards emphasizes that for people who regularly visit their PCP, most issues with the thyroid can be detected and diagnosed. PCPs are trained to diagnose thyroid problems and can refer patients to an endocrinologist if additional specialized care is needed.
Patrick Richards, MD
Treatment and Care
Thyroid disease treatments are specific to each diagnosis and each patient. General treatment options can include addressing thyroid hormone levels, taking medications or surgery. Treatment options for thyroid cancer can include radiation therapy, or a thyroidectomy (surgical removal of all or part of the thyroid gland).
While there is no prescribed diet for thyroid disease, a nutrient-rich, high-fiber, low-in-sugar diet is recommended. It’s important to note that there is no real “cure” for thyroid diseases, but with the appropriate treatments, normal thyroid function can be restored. “If you visit your PCP as recommended, thyroid issues can be properly managed and there can be minimal impact on quality of life,” says Dr. Richards.
Living with a thyroid disease can be easily managed with the right treatment and care plan from your doctor, so don't delay annual wellness exams. These are the visits that can help diagnose issues early on and help determine the best course of action.
If you or a loved one are experiencing symptoms related to possible thyroid disease, reach out to your PCP to begin the discussion about your care options.