Thyroid: When the Body's Regulator Goes Wrong

Have you ever heard someone say, "I must have an overactive thyroid," to explain how they keep their weight down despite a hearty appetite? Or, conversely, hearing an overweight or obese person blame their girth on an underactive thyroid?

 

Although the thyroid gland does regulate the rate at which food is converted into energy, it may not necessarily explain your body's shape and silhouette. Your weight can be influenced by your diet, activity level, genetics and other factors. But the thyroid gland, located in the front of the neck, is extremely important to your overall well-being. It makes and stores hormones that also help regulate heart rate, blood pressure and body temperature. It's about the size of a quarter and shaped like a butterfly or bow tie.

 

Occasionally the thyroid stops functioning properly. It can become overactive, producing too much thyroid hormone (a condition called hyperthyroidism) or underactive, producing too little hormone (called hypothyroidism). Both hypothyroidism and hyperthyroidism can be treated effectively.

 

Underactive Thyroid

"Hypothyroidism affects an estimated 4% to 8% of the population," he says, adding: "It affects 5 to 10 times as many women as men, often in their mid-50s." Why more women? "Hypothyroidism is usually due to an autoimmune disorder in which the body attacks its own cells or tissues. Autoimmune conditions, like lupus or rheumatoid arthritis, are frequently more common in women."

Hypothyroidism can occur gradually or suddenly, and its symptoms can be confused with other medical problems. Some symptoms of hypothyroidism are:

• Unexplained weight gain
• Constipation
• Cold intolerance
• Dry skin
• Fatigue
• Menstrual irregularities
• Joint pain
• A mass in the neck, also called a goiter
• A change in the voice

Overactive Thyroid
Graves' disease is the most common hyperthyroid condition. Some of its symptoms can be the reverse of those found in Hashimoto's. Graves' disease patients may experience:

·  Heart palpitations

·  Tremors

·  Unexplained weight loss

·  Intolerance to heat

·  Overactive bowels

·  Skin discoloration

·  Changes in eyes and vision, including bulging of one or both eyes

·  Nervousness, anxiety, difficulty sleeping

As with Hashimoto's hypothyroidism, diagnosing Graves' and other hyperthyroid conditions involves a blood test to measure the level of thyroid hormone and TSH, along with a thyroid scan. A physical exam can confirm whether the thyroid is enlarged.

"Graves' disease can be treated three ways, depending on the patient's age and medical condition" . "These include medications to block the thyroid gland's ability to make new thyroid hormone. We can also use radioactive iodine to shrink the thyroid to reduce the overactivity, or surgery to remove some or all of the gland." Afterward, patients may develop hypothyroidism, which can be treated with appropriate hormone therapy, as is done with Hashimoto's patients.  

·  Thyroid Nodules
"Since nodules are relatively asymptomatic, they're often first detected by a physician during a physical examination,"  "Occasionally, a patient might also feel a mass or lump. If the nodule is fairly large, they could experience difficulty swallowing, a change in their voice, coughing or a breathing problem."

Nodules not only vary in size, they can also be solid or be filled with fluid. Some nodules can be malignant. Thyroid cancer is relatively uncommon, compared with such cancers as lung, colorectal, breast and prostate.