FAQ Thyroid Awareness

By Eric M. Folkens, M.D., Family Medicine,
Bradenton/Lakewood Ranch/Sarasota Urgent Care Walk-In Clinics

What is the thyroid gland?
The thyroid gland located in the neck produces thyroid hormones which help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working normally.

How important is my thyroid in my overall well-being?
The thyroid gland produces thyroid hormone, which controls virtually every cell, tissue and organ in the body. If your thyroid is not functioning properly, it can produce too much thyroid hormone, which causes the body’s systems to speed up (hyperthyroidism); or it can create too little thyroid hormone, which causes the body’s systems to slow down (hypothyroidism).

Untreated thyroid disease may lead to elevated cholesterol levels and subsequent heart disease, as well as infertility and osteoporosis. Research also shows that there is a strong genetic link between thyroid disease and other autoimmune diseases, including types of diabetes, arthritis and anemia.

Simply put, if your thyroid gland isn’t working properly, neither are you.

How can I tell if my thyroid is working properly?
Both an underactive and overactive thyroid gland can cause symptoms. If you are experiencing symptoms such as fatigue, depression or anxiety, changes in sleep, changes in weight, intolerance to hot or cold temperature, hair loss, dry skin, muscles aches or tremors, or menstrual irregularities, you may have a thyroid problem. Additionally, symptoms of thyroid enlargement such as a swelling in the neck, hoarse voice, or increased discomfort wearing neckties or turtlenecks, should prompt a thyroid investigation. Ask your doctor to test your thyroid function if you are experiencing any of these symptoms.

What is thyroid disease?
Thyroid disease encompasses a large variety of problems with the thyroid. The thyroid can be become underactive (hypothyroid) or overactive (hyperthyroid) for many different reasons. Blood tests are usually the first step in diagnosing thyroid disease. The thyroid can also become enlarged (goiter) or develop nodules (growths within the thyroid). Based on physical exam and blood tests your doctor can determine if other studies are needed such as ultrasound, thyroid scan, or biopsy and the appropriate treatment.

How common is thyroid disease?
Thyroid disease is more common than diabetes or heart disease. Thyroid disease is a fact of life for as many as 30 million Americans – and more than half of those people remain undiagnosed.

What causes hyperthyroidism?
Hyperthyroidism, or overactive thyroid, can be caused by a number of conditions affecting the thyroid. Common causes of hyperthyroidism include Graves disease, toxic nodule, toxic multinodular goiter, thyroiditis, excess TSH secretion, taking excess thyroid hormone, or excess iodine intake.

Graves disease is an autoimmune disorder characterized by generalized overactivity of the thyroid gland. It is more common in women and may be hereditary. Alternatively, the overactivity may be centered in areas of overgrowth, called nodules. When there is one or more overfunctioning nodules, this is called a toxic nodule or toxic multinodular goiter. Thyroiditis, or inflammation of the thyroid, may be associated with both hyper and hypothyroidism. Thyroiditis may occur following a viral infection or after pregnancy. Rarely, excess TSH secretion from the pituitary gland in the brain may cause hyperthyroidism. Excess iodine intake is also rare, and may be due to specific drugs, such as amiodarone.

What causes hypothyroidism?
Primary hypothyroidism is caused by an underlying disease of the thyroid.

The most common causes of primary hypothyroidism are autoimmune thyroiditis (i.e. Hashimoto’s thyroiditis or lymphocytic thyroiditis), surgical removal of the thyroid (i.e. thyroidectomy), radioactive iodine treatment, or certain medications such as Lithium, Amiodarone.

Secondary hypothyroidism is a much less common problem. It is caused by diseases that affect the pituitary gland’s ability to make and release TSH (which regulates thyroid hormone production). Specific problems include pituitary tumors, postpartum pituitary necrosis (Sheehan’s syndrome — an uncommon problem where all or part of the pituitary dies after childbirth), trauma, or tumors that grow into the pituitary gland.

When should I get tested for thyroid
dysfunction?
The thyroid gland is an important organ that secretes a hormone (thyroid hormone), which controls the body’s metabolism. Thyroid hormone affects many bodily functions including heart contractility, gastrointestinal motility, and bone mineralization/turnover, among others. These functions are increased in patients who have hyperthyroidism, and decreased in patients with hypothyroidism. Symptoms of hyperthyroidism include palpitations, insomnia, or weight loss, while hypothyroid patients may have fatigue, weight gain, dry skin, or constipation. If you have any of these symptoms, you should go to your healthcare provider for a thorough history and physical exam. Your provider will use information gained from such an evaluation to determine if testing is right for you.

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