Thyroid Health Fact Sheet: Your Complete Guide To A Healthy Thyroid

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thyroid examination

Thyroid health is not the most fundamental concern for many. However, our thyroid plays some of the most important roles in our overall bodily functions. Thyroid diseases aren’t the easiest to diagnose either, but they can be just as serious as other health conditions.

While the recent developments in healthcare and medicine have already done so much, it still pays off to actually know and understand what your body is going through. As others would say, “listen to your body”. Learn to interpret what your body is trying telling you.

In the context of thyroid health, how could you possibly know if your thyroid is no longer functioning normally? Well, read on and this guide should teach you just that.

Get to know your thyroid gland

Face the mirror, chin up and feel your Adam’s apple. Right below that chunk of cartilage is where the butterfly-shaped thyroid gland is located. Here's an illustration to help you locate it...

diagram of the thyroid gland


Our thyroid is one of the major parts of the endocrine system which means that it is one of those glands that secretes hormones into the blood to be carried out to the different organs in the body. Speaking of hormones, the thyroid gland produces three types: Triiodothyronine (T3), Thyroxine (T4), and Diiodothyronine (T2).

T4 makes up 90% of all hormones secreted by the thyroid gland and T3 is its active form. T4 is converted into T3 by our liver through the help of an enzyme called deiodinase. T3 is also said to be the most powerful thyroid hormone. T2, on the other hand, is still under further studies and experts are yet to gain a better understanding of this particular hormone.

Generally, these hormones pose major influence on our overall growth and development, including our metabolism, brain function, heart rate, and digestive functions among others. They also interact with other hormones in the body such as the sex hormones (estrogen, testosterone, and progesterone), insulin, and many others.

Basically, our thyroid can easily make or break some of the major processes in our body which leads us to the next part of this guide.

Iodine and thyroid health

For some people who know at least a thing or two about thyroid health, one of the first things that come to mind is the iodine levels in the body. Apparently, iodine can influence the production of thyroid hormones which will, later on, determine our thyroid’s overall health.

Iodine is one of the naturally occurring chemical elements that we know of. It can be found in seawater, freshwater, and even on land. Ironically, iodine deficiency is still a reality in some people. The medical term for such condition is IDD or Iodine Deficiency Disorder.

On the other hand, it is also possible for others to unconsciously take in too much iodine through their diet which can similarly affect the production of thyroid hormones.

Now, you might wonder what makes iodine so special. Well, here’s how it works.

Thyroid hormones, both T3 and T4, are synthesized from iodine and an amino acid called tyrosine. So naturally, if there is too little iodine in the body, the thyroid gland is unable to produce enough thyroid hormones. On the contrary, when there is too much iodine present in the body, the thyroid gland reacts accordingly by producing higher amounts of thyroid hormones.

Therefore, in either situation--too much iodine or the lack thereof--there is a greater chance for a thyroid problem to develop sooner or later.

However, there is more to this whole thyroid hormone production than just the iodine levels in our blood. In fact, the whole process is more complex than most of us would have expected. A detailed discussion of the topic is covered in the section below.

Thyroid problems: An overview

Thyroid hormone synthesis initially starts in the hypothalamus which is found at the base of the brain. The hypothalamus links the nervous system and the endocrine system through the pituitary gland. Now, here’s how it gets a little interesting.

First, the hypothalamus releases a thyrotropin-releasing hormone (TRH) into the pituitary gland which will, in turn, release thyrotropin into the blood. Thyrotropin is also referred to as thyroid-stimulating hormone (TSH).

Once the TSH reaches the thyroid gland, thyroid hormone production then begins which, of course, is made possible with the help of the iodine in our blood.

In the midst of all this, the pituitary gland carefully senses the hormone levels in our blood. So, when there is an overproduction of thyroid hormones, both the TRH and TSH levels are adjusted accordingly. The main goal is to decrease the amount of TSH released from the pituitary gland which clearly has the direct influence on the production of hormones in the thyroid gland.

While there is a little chance for inaccuracies to arise in this whole cycle, it is still possible. In that case, there can also be a slight possibility for thyroid problems to develop. Most of the time, the main causes of thyroid issues are found within the thyroid gland itself.

Thyroid-related health issues develop more often in women than in men and that is perhaps one of the most inconvenient truths about thyroid health that women have to deal with. So, in the next section, we have dedicated an entire discussion to shed more light on the topic.

Women and thyroid health

Generally, women are more susceptible to autoimmune diseases compared to men. So, it’s not much of a surprise if thyroid diseases are found mostly in women, especially those over the age of 60. While that is an established fact, there is no definite explanation as to why this is the case.

There are, however, a number of theories that experts have looked into. One of those has something to do with women’s hormones. Apparently, women’s hormonal matrix is too complex. From puberty to pregnancy and eventually during perimenopause and menopausal stage, women often experience hormonal unrest. During these stages in a woman’s life, she is believed to be the most vulnerable to developing thyroid problems.

The female hormone called estrogen is considered as one of the main culprits. Remember how thyroid hormones interact with other hormones in the body? Well, estrogen can potentially alter the production of thyroid hormones in the thyroid gland. More specifically by limiting its ability to produce thyroid hormones.

If a woman has a condition called estrogen dominance wherein the estrogen level is relatively higher in relation to the amount of progesterone in the body, she will most likely have an underactive thyroid or hypothyroidism. This may lead to infertility, irregular menstrual cycle, and premenstrual syndrome among others.

In the case of pregnant women with an undiagnosed or untreated thyroid disease, they will require immediate medical attention especially in the first few months of pregnancy. Note that untreated thyroid diseases during pregnancy can cause miscarriage, premature birth, preeclampsia, anemia, and other birth complications.

Based on these information, it goes without saying that women should be more aware of the current state of their thyroid in order to prevent complications or to properly manage existing thyroid conditions. That said, let’s take a closer look at the different thyroid issues and learn more about them in the following sections below.

Underactive thyroid

Hypothyroidism is the medical term for a condition that involves an underactive thyroid gland or when there is an underproduction of thyroid hormones. While this is primarily linked to iodine deficiency, hypothyroidism in pregnant women can be caused by an underlying autoimmune disorder called Hashimoto’s Thyroiditis.

You will learn more about this and other causes of hypothyroidism in the next part of this section, including the symptoms that you should be looking out for.

Potential causes of hypothyroidism

Hashimoto’s Thyroiditis

Hashimoto’s is the most common type of thyroiditis or the inflammation of the thyroid gland. As an autoimmune disorder, the condition triggers the immune cells to attack healthy tissues in the body. In this case, the thyroid gland. Naturally, this will have a negative effect on the thyroid’s ability to produce thyroid hormones which then results in hypothyroidism.

 

Antithyroid antibodies

As the name suggests, these antibodies specifically target the thyroid gland, causing inflammation and an impairment in its thyroid hormone production ability just like what Hashimoto’s disease does. Unfortunately, there are other medical conditions that may also lead to the production of antithyroid antibodies.

People with lupus, chronic hepatitis, type 1 diabetes, and rheumatoid arthritis among others may have these antibodies as well. Thus, making them susceptible to hypothyroidism.

 

Thyroid surgery

Thyroid surgery is performed by removing a part or all of the thyroid gland in order to treat certain thyroid disorders. In the case wherein only a part of the thyroid gland is removed and the remaining tissues fail to retain their normal function, this can lead to hypothyroidism. The same is true when the entire thyroid gland is removed.

 

Medications and treatment

Lithium is one of the most common medications that can hamper the normal thyroid hormone production of the thyroid gland. Other drugs with the same potential effect are interferon-alpha, nitroprusside, thalidomide, amiodarone, sulfonylureas, and perchlorate among others.

Certain treatments can also damage the thyroid gland and ultimately, affect its ability to produce sufficient thyroid hormones. Radioactive iodine therapy used to treat hyperthyroidism and external beam radiation used to combat certain types of cancers are the best examples of these types of treatments.

 

Congenital defects

If you can recall our discussion on thyroid hormone synthesis, there are different steps involved in the whole process. If a child is born with a defect in any of those steps or if the baby’s thyroid gland is simply not functioning properly, this can result in underproduction of thyroid hormones or hypothyroidism.

On a lighter note, a newborn screening will allow doctors to diagnose hypothyroidism in babies. So, this is particularly beneficial in terms of determining the right treatment and proper management of the disease at its earliest stage.

Symptoms of hypothyroidism

Constipation

Note that constipation is a common symptom of hypothyroidism in infants, children, and in the early stages of the condition among adults.

 

Lethargy

An infant suffering from hypothyroidism will appear sluggish. While it is normal for babies to sleep for long hours, excessive sleeping is something to look out for especially when the said behavior is accompanied by other symptoms of hypothyroidism.

Children, on the other hand, will show signs of excessive fatigue and some evident behavioral changes, especially in their school performance.

Lethargy is also an early sign of hypothyroidism among adults. Easy fatigue and exhaustion are usually what the patient experiences.

 

Poor appetite

Infants with hypothyroidism will feed poorly and might even choke while nursing. Adults, however, will manifest this symptom at the later stage of the condition.

 

Delay in growth and development

Delayed growth and development are common indications of hypothyroidism in infants and children. However, the delay is usually more severe among infants.

Some of the specific symptoms to look out for are stunted growth, delayed appearance of teeth, poor hair and nail growth, and relatively shorter toes and fingers compared to a healthy baby of the same age.

Children and teens, on the other hand, will experience a delay in physical and sexual development. This will usually result in poor growth and delayed puberty.

 

Dry skin

Having a dry skin may not sound alarming at first, but if we’re talking about rough and scaly skin that doesn’t show any improvement whatsoever with moisturizers, then it could be a sign of hypothyroidism.

 

Sensitivity to cold

People with hypothyroidism usually feel cold most of the time or they simply can’t tolerate cold temperatures. In fact, they don’t warm up or sweat easily even during exercise.

 

Hair loss

Hair loss is not just a sign of unhealthy or brittle hair. It could also be a symptom of hypothyroidism. Women, in particular, should be watchful of any signs of unexplained hair loss as this may indicate a problem with their thyroid.

 

Hoarse voice

Our thyroid gland sits right below our voice box, so any issues in the thyroid can potentially affect our normal speaking voice.

As previously discussed, a hypoactive thyroid would lead to an underproduction of thyroid hormones. The lack of thyroxine (T4) in the blood can cause the vocal cords to thicken and ultimately result in a deep and hoarse voice.

 

Irregular or lack of menstrual period

The thyroid gland helps regulate women’s menstrual cycle. Hence, thyroid problems in general can cause irregular or lack of periods. In fact, there are instances wherein a woman’s menstrual cycle is delayed for several months due to an untreated thyroid disease. This condition is known as amenorrhea.

 

Weight gain

Since our thyroid also regulates our metabolism, it is only natural for a person with low levels of thyroid hormones to gain weight. The lack of thyroid hormones will slow your metabolism down, leading to weight gain despite following a strict diet and rigorous exercise.

 

Hyperactive thyroid

A hyperactive thyroid secretes too much thyroid hormones in the blood. This condition is known as hyperthyroidism. Although it is a relatively rare condition compared to hypothyroidism, it is just as serious as the latter especially when left untreated.

That said, it’s only reasonable to also get yourself acquainted with its causes and symptoms. Below are some of the most important things you need to know about the condition.

Potential causes of hyperthyroidism

Graves' disease

Graves’ disease is considered to be the most common cause of hyperthyroidism. It is an autoimmune disease also referred to as toxic diffuse goiter.

The condition involves an overstimulated thyroid that results to goiter. Thyroid stimulating immunoglobulins (TSI) are usually seen as the main contributing factor to its existence. TSIs bind with thyrotropin (TSH) receptors and mimics the hormone’s function, causing the thyroid to be overly stimulated. As a result, excessive amounts of thyroid hormones are secreted into the blood, leading to hyperthyroidism.

Note that Grave’s disease may result in an eye complication called Grave’s Ophthalmopathy. This is evident in patients with eyes that seem to protrude. This appearance is mainly caused by the swelling behind the eyeballs and the surrounding tissues of the eyes.

As the disease progresses, patients will experience severe eye pain, and weakened eye muscles resulting in watery eyes and double vision. Worst case scenario, the condition can lead to loss of vision.

 

Toxic multinodular goiter

As we age, our thyroid gland may develop a number of lumps or nodules. These lumps don’t typically produce any thyroid hormones and therefore, they are harmless and require no treatment.

In some cases, however, one or more of these nodules can become autonomous and will no longer respond to TSH or to the regulating ability of the pituitary gland. As a result, they will start to produce thyroid hormones on their own.

This condition usually happens when the nodule grows to as big as 3cm. Note that if there is only one nodule involved, it is referred to as a functioning nodule or functioning adenoma. If there are multiple nodules in question, the right medical term for the condition is multinodular goiter.

 

Pituitary adenoma

In very rare cases, a tumor will grow within the pituitary gland and start producing TSH independently. As previously discussed, TSH is what signals the thyroid to produce hormones. So, if a pituitary adenoma develops, it will most likely lead to hyperthyroidism.

 

Thyroiditis

The thyroid gland can become inflamed due to a viral infection. This condition is known as subacute thyroiditis. In some cases, the inflammation is accompanied by an accumulation of white blood cells or lymphocytes. Hence, the medical term lymphocytic thyroiditis.

In both situations, thyroid hormones are believed to leak out from the thyroid gland causing an increase of such hormones in the blood. Note that lymphocytic thyroiditis is more common among women who have just given birth.

 

Drug-induced

Medications that contain high amounts of iodine can potentially cause hyperthyroidism particularly in patients with an underlying thyroid condition. A good example of such drug is amiodarone (Cordarone)--a medication used to treat heart problems.

Ironically, thyroid hormone medications can also be associated with hyperthyroidism. This usually happens when the patient is unconsciously overdosing on the medication or intentionally abusing it to increase metabolism and eventually lose weight.

 

Symptoms of hyperthyroidism

Hyperkinesis

Hyperkinesis is basically hyperactivity. This symptom is mostly seen among children with hyperthyroidism. Aside from the heightened need for activity, hyperthyroid children may also show some difficulty or inability to concentrate.

 

Insomnia and sleep disturbances

Hyperthyroidism can overstimulate our nervous system which explains the episodes of insomnia and sleep disturbances that are often accompanied by night sweats.

 

Tremors

Patients with a hyperactive thyroid may experience tremors that usually involves fine shaking of the hands. This is just one of the many signs that your body’s processes are speeding up in order to keep up with your thyroid.

 

Weight loss

As we already know, our thyroid gland helps regulate our body’s metabolism. So, if there is an overproduction of thyroid hormones, this can easily accelerate our metabolic rate and ultimately lead to sudden weight loss despite having a good and normal appetite.

 

Heat intolerance

People suffering from hyperthyroidism often feel hot even under normal or cold temperatures and may experience excessive sweating.

 

Increased bowel movement

Hyperthyroidism can speed up your digestive system which explains the frequent bowel movement or loose stools. Note that there is a difference between increased bowel movement and diarrhea. Although the latter can be possible, it is more uncommon.

 

Rapid pulse and heart palpitations

Thyroid hormones can cause some physiologic effects on our heart. Therefore, excessive thyroid hormones can lead to a heart rate of more than 90 beats per minute even when the person is at rest. This is why tachycardia or rapid heart rate is considered as one of the most common indications of hyperthyroidism.

 

Angina (chest pain) and shortness of breath

These symptoms are more common among elderly people especially those who are suffering from heart disease or heart failure.

 

Anxiety and irritability

People with a hyperthyroid often feel anxious and irritable. They can experience nervousness, mood swings, agitation, and even panic attacks.

 

Fatigue and weakness

Fatigue can be a symptom of both hypo- and hyperthyroidism. However, in the case of the latter, the lethargic feeling usually results from other symptoms of hyperthyroidism such as anxiety, irregular sleeping patterns, and insomnia.

Thyroid goiter and nodules

Thyroid goiter and thyroid nodules have been mentioned quite a few times in the previous topics. So, this section will simply provide an in-depth discussion about the subject.

 

Thyroid goiter can be described as the enlargement of the thyroid gland. In fact, this enlargement is the primary indication of the said condition. When a person’s thyroid grows large enough, this can create pressure in the surrounding areas of the neck including the trachea, esophagus, and the blood vessels.

Thyroid nodules, on the other hand, are lumps that grow within the thyroid gland. As mentioned in our previous discussions, these nodules are initially harmless but may develop into a multinodular goiter.

People with these conditions may feel constant pressure in the lower front part their necks. They might even experience a mild and dry cough that seems to aggravate when lying down. Difficulty in swallowing dry food and large pills is also another symptom.

Thyroid cancer

Thyroid cancer is a rare condition and it is considered as the least fatal type of cancer. The most common type of thyroid cancer is papillary carcinoma, making up around 80% of all the reported thyroid cancer cases.

The initial sign of this condition is the development of nodules or lumps that can appear as a solid and irregular mass in the neck. Initially, only around 5% of these nodules are malignant which explains the rarity of the case.

However, in the event that a cancer such as papillary carcinoma does develop, the treatment usually involves surgery and radioactive iodine therapy. The good news is, papillary carcinoma has a high cure rate.

Diagnosing thyroid health issues

There are a number of ways to determine our thyroid’s current state. Initially, the doctor will ask about the patient’s medical history and perform a physical exam. However, there are specific procedures that are done in order to accurately diagnose a thyroid issue. Here are some examples:

Blood test

A blood test is necessary to determine the amount of thyroid hormones present in the patient’s blood. High concentrations of T3 and T4 indicates hyperthyroidism while the opposite can indicate hypothyroidism.

The blood test can also detect the presence of TSH receptor antibody and antithyroid antibody. In the case that these antibodies are found in the patient’s blood, there is a huge possibility that the patient is suffering from either Grave’s disease or Hashimoto’s disease

Thyroid ultrasound

An ultrasound may be required in order to determine the presence of nodules in the thyroid gland. The procedure will also show the number and size of those nodules.

Nuclear thyroid scan

A nuclear thyroid scan is a specialized imaging procedure that is often performed in pregnant women who are suspected to have some type of thyroid disease.

First, the patient is administered with a radionuclide that can come in a pill, liquid, or injection form. Then, once the radioactive iodine is absorbed by the body, a scanner or a camera will be used to take an image of the patient’s thyroid gland.

Another procedure called radioactive iodine uptake test (RAIU) can also be performed 6 to 24 hours after the radioactive iodine is administered. This test doesn’t involve imaging, but instead, it uses a probe to determine the radioactivity of the thyroid gland.

Fine-needle aspiration

The procedure involves the insertion of a thin needle into the thyroid gland. The goal is to get a sample of the thyroid tissue or nodule which will then be examined for any signs of cancer.

Thyroid supplements: fact or fiction?

There are varied opinions about the effectivity and safety of thyroid supplements. Some people have been using them for a while and they claim to have experienced their benefits. However, it seems that there will always be a cloud of doubt surrounding these supplements, especially among the medical practitioners.

Thyroid supplements are meant to boost the thyroid activity of people suffering from hypothyroidism. Others, however, take advantage of their metabolic effects to lose weight. While these supplements sound very promising, some people choose to completely avoid them.

One of the main concerns of experts is the fact that these supplements may contain real thyroid hormones. Note that ingesting such can easily alter the current thyroid hormone level in the body. This is alarming in the sense that any slight changes in these levels can ultimately lead to health issues.

Another point to consider is that these supplements can contain iodine. Although iodine is not necessarily harmful to the body, excessive intake of iodine can contribute to the development of thyroid issues. Note that we only need 150 mcg of iodine daily.

At the end of the day, it all comes down to the contents or ingredients of these supplements. Therefore, consumers should feel the need to educate themselves first before considering the idea of taking any thyroid supplement.

The thyroid diet

One of the most effective ways to improve our thyroid health is to follow a thyroid-friendly diet that best fits our current thyroid state.

For people with an underactive thyroid, it is best to choose those foods that can naturally boost thyroid function. These can include fish, brazil nuts, seaweed, shellfish, legumes, and fibrous foods among others. Also, don’t forget to keep yourself hydrated.

For those suffering from hyperthyroidism, on the hand, can stick to eating lean meats, brown rice, green tea, and some raw veggies.

Prevention tips

Although some types of thyroid issues can’t be prevented, this should not stop us from doing significant steps to proactively keep our thyroid gland performing at its best. Here are some tips on how you can keep your thyroid healthy.

Free yourself from stress

Stress is known to affect our hormones and aggravate inflammation. You can keep yourself stress-free by doing some yoga or meditation during your free time. Choose an activity that will help you relax and maintain a positive vibe.

Drink enough water

Water has the ability to flush out toxins. It may not directly prevent thyroid issues, but it will help your cells and organs function properly.

Stay active

Staying active by doing some exercise can reduce stress and improve sleep while helping you maintain a healthy weight.

Take care of your liver

In our discussion about thyroid hormone synthesis, we’ve learned that the T4 hormone is converted to T3 in our liver. So, it is only reasonable for us to take care of our liver by eating foods that are high in antioxidants.

Stick to good fats

Fatty acids found in raw nuts, fish, and some healthy oils can help keep our thyroid cells healthy and decrease inflammation in some types of thyroid diseases.

The bottomline

The thyroid gland is not the largest gland or organ in our body, but it can influence a lot of bodily processes and functions. So, keeping it healthy is necessary to maintain our overall health. Thyroid issues may not be the easiest to detect, but they can be prevented.

At the end of the day, it all boils down to how well we take care of our own body and how carefully we listen to what it is trying to tell us. After all, nobody knows our body more than we do. So, take the responsibility and keep that thyroid healthy.

 

"Our content does not constitute a medical consultation.

See a certified medical professional for diagnosis."


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