Thyroid Problems Explained

Woman with thyroid problems holding her neck.

Are You Having Thyroid Problems?

It's hard to tell if you have thyroid abnormalities. You might feel run down and tired, or have what is known as "brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious, or sweat a lot more than usual. All of these are common symptoms of thyroid disorders. The thyroid gland regulates many processes within the body, and women are particularly likely to have disorders that affect the function of this essential gland. Recognizing and treating these conditions is critical for optimum health and preventing long-term health problems.

A picture of the thyroid gland

Thyroid Gland

The thyroid gland is located in front of the neck. It has right and left lobes that confer a butterfly-shaped appearance. The hormones produced by this gland control the body's metabolism, or the processes by which the body uses energy. Disorders that affect thyroid function can either speed up or slow down metabolic processes, which can lead to a wide range of symptoms.

A woman gained weight because of thyroid problems.

Hypothyroidism and Hyperthyroidism Symptoms: Weight Loss/Weight Gain

Changes in weight can signal an abnormal function of the thyroid gland. Low levels of thyroid hormones (hypothyroidism) can cause weight gain, while unexpected weight loss can signal that too much thyroid hormone is being produced (hyperthyroidism). Hypothyroidism is much more common than hyperthyroidism.

A woman’s profile showing a swollen thyroid.

Hypothyroidism and Hyperthyroidism Symptoms: Swollen Neck

A goiter is an enlargement of the thyroid gland. As shown here, an enlarged thyroid can be seen as a swelling in the front of the neck. A goiter can occur with either hypothyroidism or hyperthyroidism. It can sometimes also result from tumors or nodules that develop within the thyroid gland.

A nurse checking a patient’s pulse.

Hypothyroidism and Hyperthyroidism Symptoms: Changes in Heart Rate

The hormones made in the thyroid gland affect almost every organ in the body, including the heart. Hypothyroidism can cause the heart to beat more slowly, while hyperthyroidism causes a fast heartbeat. Elevated levels of thyroid hormones also can lead to increases in blood pressure and the sense that your heart is pounding (palpitations).

A woman with thyroid problems is feeling fatigued.

Hypothyroidism and Hyperthyroidism Symptoms: Changes in Mood

Thyroid disorders can affect emotions, energy, and mood. Hypothyroidism can cause symptoms like depression, tiredness, and feeling sluggish. Hyperthyroidism is associated with sleep disturbances, irritability, anxiety, and restlessness.

Strands of hair on a hairbrush due to thyroid hair loss.

Hypothyroidism and Hyperthyroidism Symptoms: Hair Loss

Hair loss is a common sign of a thyroid problem. Both too high and too low levels of thyroid hormones can lead to hair loss. The hair typically grows back once the condition is treated.

A woman suffering changes in temperature because of thyroid problems.

Hypothyroidism and Hyperthyroidism Symptoms: Body Temperature

The thyroid affects regulation of body temperature, so those with hypothyroidism often report feeling cold. In contrast, people with hyperthyroidism tend to have excessive sweating and an aversion to heat.

Woman touching thyroid.

Hypothyroidism and Hyperthyroidism Symptoms: Other Symptoms

Other symptoms and signs of hypothyroidism include:

  • Constipation
  • Changes or abnormalities in the menstrual cycle
  • Dry skin and brittle nails
  • Tingling and numbness in the hands or fingers

A woman trying on glasses at the optometrist because her vision has changed due to hyperthyroidism.

Hypothyroidism and Hyperthyroidism Symptoms: Other Symptoms

Other symptoms and signs of hyperthyroidism include:

  • Problems with vision
  • Diarrhea
  • Irregularities in the menstrual cycle
  • Trembling hands
  • Muscle weakness

Middle aged woman using an electric fan to cool down.

Is It Menopause or Thyroid Disorder?

Thyroid disorders can cause symptoms that are mistaken for those of a woman approaching menopause. Both menstrual cycle changes and mood changes can result from the menopausal transition or from thyroid conditions. Blood tests can determine which of these conditions is responsible for your symptoms. It's also possible to have a combination of the two causes.

A doctor checks a woman’s thyroid for swelling and discomfort.

When Should You See a Doctor?

Your doctor may recommend tests if you have symptoms or risk factors for thyroid disease. Both hypothyroidism and hyperthyroidism are most common in women over 60 years of age. A family history of thyroid disease increases your risk of developing thyroid conditions.

A woman does a thyroid neck check in the mirror.

Neck Check for Thyroid Disorders

Examining your neck in the area of the Adam's apple while you swallow can sometimes detect if your thyroid is enlarged. Swallow while tipping the head back, and examine your neck and the area above the collarbones. If you see any lumps or bulges, see a doctor.

A collection of blood test tubes used to diagnose thyroid problems.

Thyroid Disorders Tests

Blood tests can diagnose many thyroid conditions. Thyroid-stimulating hormone (TSH) is a hormone that controls activity of the thyroid gland. If your TSH is high, this typically signals that your thyroid function is low (hypothyroidism). In contrast, low levels of TSH suggest hyperthyroidism. Your doctor may also order tests to determine the levels of other thyroid hormones. Imaging studies and tissue biopsies are other tests that are sometimes used to evaluate thyroid problems.

Illustration of Hashimoto's disease shows white blood cells attacking the thyroid gland.

Hypothyroidism Causes: Hashimoto’s Disease

Hashimoto's disease, an autoimmune condition, is the most common cause of hypothyroidism. In Hashimoto's disease the immune system mistakenly targets and damages the thyroid gland, so not enough hormones are produced. Hashimoto's disease tends to run in families.

Illustration of the pituitary gland highlighted in a human brain.

Hypothyroidism Causes: Pituitary Gland

The pituitary gland is located at the base of the brain. It controls the functions of many other glands in the body, including the thyroid. The pituitary gland produces TSH, which signals the thyroid gland to make thyroid hormones. If there is a problem with the pituitary gland and not enough TSH is produced, hypothyroidism can result. Inflammation of the thyroid and taking certain medications can also cause low thyroid hormone levels.

An example of bulging eyes due to Graves' disease.

Hypothyroidism Causes: Grave’s Disease

Graves' disease is the most common cause of elevated thyroid hormone levels. This is another autoimmune condition in which the immune system targets the thyroid gland.


What Is Grave’s Disease?

In Grave's Disease, the immune system attack triggers the release of high levels of thyroid hormones. A swelling behind the eyes is one of the characteristic signs of Graves' disease, as shown in this photo.

A scan shows a nodule in the thyroid gland.

Hypothyroidism Causes: Thyroid Nodules

Thyroid nodules are lumps that are found inside the thyroid gland. These lumps can begin producing high levels of thyroid hormones, leading to hyperthyroidism. Large lumps may be obvious, while smaller nodules can be visualized with an ultrasound examination of the thyroid.

Doctor discusses thyroid issues with a patient.

Thyroid Storm

Untreated hypothyroidism can raise cholesterol levels and increase your risk of heart attack or stroke. If thyroid hormone levels drop to extreme lows, coma and a life-threatening lowering of body temperature can occur. Other complications of untreated hypothyroidism include a loss of bone density and heart problems.

A woman takes pills from medication bottle to treat her hypothyroidism.

Hypothyroidism Treatment

Treatment for hypothyroidism usually involves taking thyroid hormones in pill form. Symptoms usually improve within a few weeks of beginning therapy. Most of those affected will have to take the thyroid hormones throughout their life. Over time, treatment can result in weight loss, increased energy, and lowering of cholesterol levels.

A person holding a radioactive iodine container for hyperthyroid treatment.

Hyperthyroidism Treatment

There are several treatments available to fight hyperthyroidism. The best approach can be determined by a doctor, who will likely consider how severe the hyperthyroidism is, as well as a patient's medical history.


Anti-Thyroid Medications

Antithyroid medication, which attempts to lower the amount of thyroid hormone produced, is the most common treatment for hyperthyroidism. Many people need to take this medication long-term. You may need other kinds of medication to treat certain symptoms, like tremors or fast heart rate.


Radioactive Iodine

Radioactive iodine is a treatment option that destroys the thyroid gland over a period of weeks. This is an oral medication.


Beta Blockers

Beta blockers don't actually treat thyroid level disorders, but they do improve the symptoms of high blood pressure, rapid heart rate, and heart palpitations.

Surgeons in an operating room performing a thyroidectomy.

Hyperthyroidism Treatment: Surgery (Thyroidectomy)

Surgery to remove the thyroid gland is recommended for hyperthyroidism when antithyroid drugs do not work, or if there is severe enlargement of the gland. Surgery can also be used to treat thyroid nodules or tumors. After surgical removal of the gland, most people need to take thyroid hormones in pill form.

Scintigram showing thyroid cancer.

Thyroid Cancer

Thyroid cancer is not common, and it is among the least deadly types of cancer.

Thyroid Cancer Symptoms

A lump or swelling in the thyroid gland is the most common sign, and only about 5% of thyroid nodules are malignant (cancerous).


Thyroid Cancer Treatment

Some thyroid cancer, but not all, is treated by surgery followed by radioactive iodine therapy or radiation therapy. Thyroid cancer is almost never treated with external radiation.

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REFERENCES:

  • National Endocrine and Metabolic Diseases Information Service: "Hypothyroidism"
  • Thyroid.org: "Hyperthyroidism"
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