Who is affected by thyroid disease?
Thyroid disease can affect anyone — men, women, infants, teenagers and the elderly. It can be present at birth (typically hypothyroidism) and it can develop as you age (often after menopause in women).
Thyroid disease is very common. A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.
You may be at a higher risk of developing a thyroid disease if you:
- Have a family history of thyroid disease.
- Have a medical condition (these can include pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome).
- Take a medication that’s high in iodine (amiodarone).
- Are older than 60, especially in women.
- Have had treatment for a past thyroid condition or cancer (thyroidectomy or radiation).
SYMPTOMS AND CAUSES
The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works.
Conditions that can cause hypothyroidism include:
- Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland. Thyroiditis can lower the amount of hormones your thyroid produces.
- Hashimoto’s thyroiditis: A painless disease, Hashimoto’s thyroiditis is an autoimmune condition where the body’s cells attack and damage the thyroid. This is an inherited condition.
- Postpartum thyroiditis: This condition occurs in 5% to 9% of women after childbirth. It’s usually a temporary condition.
- Iodine deficiency: Iodine is used by the thyroid to produce hormones. An iodine deficiency is an issue that affects several million people around the world..
- A non-functioning thyroid gland: Sometimes, the thyroid gland doesn’t work correctly from birth. This affects about 1 in 4,000 newborns. If left untreated, the child could have both physical and mental issues in the future. All newborns are given a screening blood test in the hospital to check their thyroid function.
Conditions that can cause hyperthyroidism include:
- Graves’ disease: In this condition the entire thyroid gland might be overactive and produce too much hormone. This problem is also called diffuse toxic goiter (enlarged thyroid gland).
- Nodules: Hyperthyroidism can be caused by nodules that are overactive within the thyroid. A single nodule is called toxic autonomously functioning thyroid nodule, while a gland with several nodules is called a toxic multi-nodular goiter.
- Thyroiditis: This disorder can be either painful or not felt at all. In thyroiditis, the thyroid releases hormones that were stored there. This can last for a few weeks or months.
- Excessive iodine: When you have too much iodine (the mineral that is used to make thyroid hormones) in your body, the thyroid makes more thyroid hormones than it needs. Excessive iodine can be found in some medications (amiodarone, a heart medication) and cough syrups.
Common symptoms
The symptoms of thyroid disease can be divided into two groups — those related to having too much thyroid hormone (hyperthyroidism) and those related to having too little thyroid hormone (hypothyroidism).
Symptoms of an overactive thyroid (hyperthyroidism) can include:
- restlessness
- nervousness
- racing heart
- irritability
- increased sweating
- shaking
- anxiety
- trouble sleeping
- thin skin
- brittle hair and nails
- muscle weakness
- weight loss
- bulging eyes in Graves’ disease)
Symptoms of underactive thyroid (hypothyroidism):
- fatigue
- dry skin
- increased sensitivity to cold
- memory problems
- constipation
- depression
- weight gain
- weakness
- slow heart rate
- coma
Diagnosis:
Blood tests
Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:
- Graves’ disease.
- Hashimoto’s disease.
- Thyroid nodule.
- Thyroid cancer.
The specific blood tests that will be done to test your thyroid can include:
- Thyroid-stimulating hormone (TSH)
- T4: Thyroxine tests for hypothyroidism and hyperthyroidism,
- FT4: Free T4 or free thyroxine
- T3: Triiodothyronine tests help diagnose hyperthyroidism or to show the severity of hyperthyroidism.
- FT3: Free T3 or free triiodothyronine
These tests alone aren’t meant to diagnose any illness but may prompt your healthcare provider to do additional testing to evaluate for a possible thyroid disorder.
Additional blood tests might include:
- Thyroid antibodies: These tests help identify different types of autoimmune thyroid conditions.
- Calcitonin: This test is used to diagnose C-cell hyperplasia and medullary thyroid cancer, both of which are rare thyroid disorders.
- Thyroglobulin: This test is used to diagnose thyroiditis (thyroid inflammation) and to monitor treatment of thyroid cancer.
Imaging tests
In many cases, taking a look at the thyroid itself can answer a lot of questions. Thyroid scan. This allows your provider to look at your thyroid to check for an increased size, shape or growths (nodules).
Ultrasound
Physical exam
Another way to quickly check the thyroid is with a physical exam in your healthcare provider’s office. This is a very simple and painless test where your provider feels your neck for any growths or enlargement of the thyroid.
MANAGEMENT AND TREATMENT
If you have high levels of thyroid hormones (hyperthyroidism), treatment options can include:
- Anti-thyroid drugs (methimazole and propylthioracil): These are medications that stop your thyroid from making hormones.
- Radioactive iodine: This treatment damages the cells of your thyroid, preventing it from making high levels of thyroid hormones.
- Beta blockers: These medications don’t change the amount of hormones in your body, but they help control your symptoms.
- Surgery: A more permanent form of treatment, your healthcare provider may surgically remove your thyroid (thyroidectomy). This will stop it from creating hormones. However, you will need to take thyroid replacement hormones for the rest of your life.
If you have low levels of thyroid hormones (hypothyroidism), the main treatment option is:
- Thyroid replacement medication: This drug is a synthetic (man-made) way to add thyroid hormones back into your body. One drug that’s commonly used is called levothyroxine. By using a medication, you can control thyroid disease and live a normal life.
