Darrick Robles When there are problems with the thyroid gland, the symptoms are often ambiguous and not easy to recognise. Therefore, we have summarized the most important things about an overactive or underactive thyroid and answer the question of when you should go to the doctor with thyroid problems.
There are some ailments that can have a number of causes, such as B. depression, fatigue or unexplained weight gain. However, if they are accompanied by other symptoms, such as sensitivity to cold or constipation, they may indicate a thyroid problem.
It is estimated that around 200 million people worldwide suffer from some form of thyroid disease. The two most common are hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid), with women being affected ten times more often than men.
What is the thyroid?
The thyroid is shaped like a small butterfly and is located at the front of the neck, just below the larynx. It produces two hormones, thyroxine (T4) and triiodothyronine (T3). In the brain, the hormone balance and accordingly the amount of thyroid hormones to be produced is controlled by the hypothalamus and the pituitary gland.
Thyroid hormones regulate energy, metabolism, body temperature, body weight, muscle strength, appetite, respiration, growth, the reproductive system, and also heart, brain, and kidney function. When your thyroid is functioning well and producing the right amount of hormones, everything runs smoothly.
But lifestyle factors are also important if you want to keep your thyroid healthy. Eating a nutritious, balanced diet, getting enough sleep, regular exercise, managing stress, and a healthy immune system go a long way to keeping your thyroid in balance.
Common thyroid diseases
There are different types of thyroid disease:
- Goiter – An abnormally enlarged thyroid gland most commonly caused by an iodine deficiency.
- Graves ‘ disease – An autoimmune disease that causes an overactive thyroid gland (see below).
- Hashimoto’s Thyroiditis – An autoimmune disease that causes an underactive thyroid (see below).
- Thyroid Nodules – Nodules in the thyroid gland, about 90% of which are usually benign.
- Thyroid Cancer – A rare type of cancer.
Since many of the symptoms of an overactive and underactive thyroid can also be attributed to numerous other reasons, we have also listed some other causes that your doctor will ask you about.
Hypothyroidism (underactive thyroid)
If the thyroid gland is underactive, not enough thyroxine (T4) and triiodothyronine (T3) are produced. When hormone levels drop, thyroid stimulating hormone (TSH) increases. As a result, patients can feel tired, depressed, and often cold . Thyroid problems are more common in women, especially during menopause. However, hypothyroidism can occur at any age.
Common symptoms include:
Fatigue When thyroid hormone levels drop, your body processes slow down. Your metabolism, heart rate and blood circulation slow down and your energy levels drop. This can make you feel exhausted.
Other common causes of fatigue include stress, lack of sleep, overwork, psychological factors, food intolerance and nutritional deficiencies, including iron deficiency (iron deficiency anemia), which can also be caused by an underactive thyroid.
Weight gain If the thyroid gland does not produce enough hormones, it can lead to a lower basal metabolic rate. When your metabolism slows, it means you’re not burning energy (calories) as efficiently, which can lead to faster weight gain.
But the reason for rapid weight gain and bloating can also be fluid retention. This is because low levels of thyroid hormone affect kidney function, which increases the likelihood of salt and water retention. This can lead to an overall puffy appearance.
Other common causes of weight gain are overeating, lack of exercise or stress. Hypothyroid weight gain is almost always accompanied by other symptoms.
Depression Thyroid hormones play an important role in maintaining healthy brain function. When they are low, it can lead to depression. For example, thyroid hormones help regulate the hypothalamic-pituitary-thyroid axis, which is involved in regulating emotions, mood, and behavior.
Depression caused by an underactive thyroid can be reversed by treating hypothyroidism.
Other common causes of depression include lack of sleep, poor diet, lack of natural light, stress, distressing life events (such as bereavement, loss of a job, or breakup of a relationship), physical, sexual, or emotional abuse, low self-esteem, traumatic events, or an unstable life housing situation. If you’re feeling depressed and it’s starting to affect your daily life, you should seek help. Talk to your doctor, who can refer you to a psychotherapist if necessary.
Constipation An underactive thyroid slows digestion. This can mean that the food you eat travels more slowly through the gastrointestinal tract, making you more prone to constipation.
Other common causes of constipation are poor diet (especially lack of fiber from foods like fruits, vegetables, beans, legumes, and whole grains), lack of exercise, and stress.
Other common underactive thyroid symptoms to tell your doctor include:
- increased sensitivity to cold
- general lethargy
- Energy deficiency
- muscle and joint pain
- fluid accumulations
- dry skin
- thinning or brittle hair; hair loss
- Menstrual irregularities in women, such as B. Heavier and more frequent menstrual bleeding
- difficulty concentrating
- swelling of the face
- a low heart rate and low blood pressure
This is how hypothyroidism is suspected
Your doctor will do a blood test and measure various values to find out what is causing the problem. If the thyroid is also enlarged, other tests, such as an ultrasound, fine-needle aspiration, and taking a sample of cells, may be done.
This is how an underactive thyroid is treated
Daily hormone replacement tablets can be administered with a doctor’s prescription. Dosage varies by individual and needs to be monitored regularly. An underactive thyroid can be a temporary condition, meaning you may not need to take any medication for an extended period of time.
Hyperthyroidism (overactive thyroid)
In hyperthyroidism, the thyroid produces too much thyroid hormone. This means that all body processes are accelerated and those affected often have the feeling that their body is running at full speed.
Common signs of an overactive thyroid are:
Weight loss (despite a normal diet) Too many thyroid hormones lead to an acceleration of the metabolism and thus to weight loss.
Other common causes of sudden weight loss can also include e.g. B. heart, kidney, lung or liver disease, problems with digestion, dental problems, dysphagia (difficulty swallowing), diabetes or dementia. A traumatic event or alcohol or drug abuse can also be associated with weight loss.
Frequent toilet visits Thyroid hormones act on the gastrointestinal tract, so excess can lead to more frequent bowel movements, including diarrhea. Kidney function can also be affected, which can result in frequent urination.
Other common causes of frequent toilet visits include diabetes, urinary tract infections, and prostate problems in men. If your bowel habits change and it is not due to a change in your diet or lifestyle, it is advisable to see a doctor.
Anxiety and anxiety Thyroid hormones help regulate the sympathetic nervous system (SNS). When the SNS becomes overstimulated, it triggers the body’s “fight-or-flight” response, resulting in increased heart rate, anxiety, irritability, mood swings, panic attacks, and impairs your ability to deal with stress.
Other common causes of stress, anxiety, and turmoil can include traumatic life events, lack of sleep, and/or poor diet. Talk to your doctor if you have anxiety and it’s interfering with your everyday life.
Other common symptoms of an overactive thyroid can include:
- nervousness
- fatigue
- feeling weak
- Palpitations and an increased heart rate
- increased sweating
- insomnia
- dry skin and hair (which may be thinning)
- mood swings
- increased sensitivity to heat
- Menstrual irregularities in women (e.g. shorter, scant and irregular periods)
- Swelling in the neck from an enlarged thyroid gland
- problems with the eyes
- tremor or shaking
If you suspect you have an overactive thyroid, you will be tested
If you suspect an overactive thyroid, your doctor may do blood tests to check your thyroid hormone levels. In some cases it may be necessary to also measure thyroid antibodies.
In addition to blood tests, your doctor will also physically examine your thyroid gland to see if it has formed lumps, changed shape, or is painful. In some cases, a fine-needle puncture and/or an ultrasound may also be necessary.
How is an overactive thyroid treated?
An overactive thyroid is usually treated by a specialist. In most cases, medications are prescribed to suppress thyroid hormone production and relieve symptoms.
Radioactive iodine treatment is sometimes offered, in which radiation damages the thyroid gland, reducing its ability to produce thyroid hormones. However, this treatment is not recommended for patients planning to become pregnant or breastfeeding.
In rare cases, surgery may be needed to remove part or all of the thyroid gland.
When to seek medical advice for thyroid problems
If you suspect your condition is thyroid related, talk to your doctor who can run the tests above. Your symptoms can have a variety of causes, but a blood test can help clarify whether you have a thyroid problem and what treatment is needed.
If a thyroid problem can be ruled out, our doctors can help you identify the cause of your symptoms and, if necessary, issue a prescription or refer you to a specialist.
