What does your thyroid do?

Gowtham Gannamani, MD

Endocrinology

Considering how big of an impact it has on our everyday health, the thyroid isn’t well understood by the average person. Chronic illnesses caused by the thyroid, like Graves’ disease and Hashimoto’s disease, may seem even more mysterious. Endocrinologist Gowtham Gannamani, MD, answered common questions about thyroid problems to help clear up misunderstandings about this often-overlooked gland in the neck.

What does your thyroid do for your body?

“Your thyroid is a small, butterfly-shaped gland located in your neck,” said Dr. Gannamani. “It’s an endocrine gland that makes and releases hormones that mainly help to control how your body uses energy, as well as affecting your heart rate, brain development, digestion, body temperature, bone health and fertility.”

To synthesize the hormones created by this gland, you need iodine, a trace mineral found naturally in some foods, most commonly consumed through iodized table salt. According to the National Institute of Health, iodine deficiency can lead to a whole host of health problems, including goiters, problems with fetal development during pregnancy and more.

Too much or too little iodine affects the level of hormones .you are able to make and release.

What are the symptoms and causes of hypothyroidism?

“Hypothyroidism occurs when the thyroid gland doesn’t make enough thyroid hormone,” said Dr. Gannamani. “It may not be obvious in its early stages, as symptoms are often not immediately noticeable.”

Symptoms of low thyroid hormones include:

• Tiredness
• Weight gain
• Constipation
• Sensitivity to cold
• Dry skin
• Thinning hair or hair loss
• Slow heart rate

Hypothyroidism can occur after the gland is removed, or after damage due to antibodies in the case of Hashimoto’s disease. In some cases, doctors may not be able to pinpoint a specific cause of why your thyroid is functioning less efficiently.

If your symptoms line up with potential hyperthyroidism, a TSH blood work test can help you learn whether your hormones are low.

What are symptoms of hyperthyroidism? What causes it?

“Hyperthyroidism involves an overactive gland producing too many hormones,” said Dr. Gannamani. “Symptoms of hyperthyroidism include losing weight without any change in diet or exercise, rapid heart rate, diarrhea, nervousness and muscle weakness.”

An autoimmune disease like Grave’s disease can cause hyperthyroidism, as well as a hyperfunctioning nodule in the gland. The TSH blood work test can help you to nail down whether your thyroid hormone production is low, high or within the normal range.

Does ‘thyroid fatigue’ feel different than fatigue from other sources? How do you know when to mention your fatigue to your doctor?

“Symptoms associated with hypo- or hyperthyroidism are often very general that could potentially be caused by a number of other conditions as well,” said Dr. Gannamani. Let your [DK1] [GG2] doctor know when your fatigue is interfering with your ability to manage routine daily activities.”

Causes of severe fatigue could include thyroid, poor sleep, nutritional deficiency and more. Bloodwork that specifically looks into your thyroid hormones can help to confirm whether your thyroid is part of the problem.

Should antibodies be checked when searching for the cause of thyroid problems?

 “First, check your thyroid-stimulating hormone level, (TSH), through a basic blood work test,” said Dr. Gannamani. “If that result comes back abnormal, then T4 (thyroxine) and T3 (triiodothyronine) levels will be checked.”

Immune cells can sometimes react against the gland, making antibodies that attack thyroid cell proteins. Measuring the levels of thyroid antibodies can help diagnose the cause of ongoing problems. Repeating these levels over time is not helpful in detecting the development of hypothyroidism or response to therapy. TSH and FT4 are what tell us about the actual thyroid function.

Dr. Gannamani noted that having a positive antibody result with normal TSH is not an indication for treatment, although it’s often a sign you are at a high risk of developing thyroid disease.

What is Graves’ disease? What is Hashimoto’s disease?

“Graves’ disease and Hashimoto’s disease are the most common causes for thyroid abnormality,” said Dr. Gannamani. “Graves’ involves a positive TSH receptor antibody that causes overactive thyroid and can cause bulging eyes, requiring separate treatment. Hashimoto’s disease, on the other hand, is a positive thyroid peroxidase antibody that causes underactive thyroid.”

How is hypothyroidism treated?

Treatment for hypothyroidism is fairly simple and includes prescribing thyroid hormone medicine. Levothyroxine, which is available under multiple different brand names, helps to balance out your hormones and doesn’t cause side effects when given in the correct dosage.

If you are having symptoms even after use of medication and with normal TSH levels, your doctor will likely look at other potential causes of these issues or speak with you about other forms of thyroid hormone that you could be given.

Can hyperthyroidism be cured? What are some treatments for hyperthyroidism?

“Hyperthyroidism involves a different level of treatment,” said Dr. Gannamani. “You may need medication or radioactive iodine treatment. Surgery is sometimes needed, as well. Which treatment is right for you depends on the cause of your hyperthyroidism, neck problems you may have, pregnancy plans or the side effects of certain medications.”

Do Graves’ disease and Hashimoto’s disease impact your quality of life?

“As long as your thyroid function (TSH) is maintained within the normal range, your quality of life shouldn’t be too heavily affected,” said Dr. Gannamani. “Treatment needs are decided and adjusted based on your ongoing TSH level.”

While hyper- and hypothyroidism can cause uncomfortable and inconvenient side effects if they go untreated, receiving treatment should help you return to the same quality of life as others.