Understanding Your Thyroid Disease - How Thyroid Hormones Fluctuate
What is Thyroid Disease?
Thyroid disease is a general medical term for various disorders that result from a dysfunctional thyroid gland.
Overview of Thyroid Gland
The thyroid is an endocrine gland of the glandular system of your body. The gland has a shape of a butterfly, with two elongated lobes on each side. It is at the base of your neck below Adam's apple and the front of your windpipe.
Your thyroid gland is an essential body organ that creates and secretes various thyroid hormones. The hormones influence your body's temperature, growth and development, and above all, metabolism.
During a child's growth, the thyroid hormones are critical in developing the child's brain besides other functions.
According to the American Thyroid Association, an estimated 20 million American population have thyroid disease. Women more likely to get thyroid disease by eight times compared to men. At least one woman in eight should develop thyroid disease in her lifetime.
There are two hormones your thyroid gland produces, thyroxine (T4) and triiodothyronine (T3). Thyroid-stimulating hormone from the pituitary gland controls the level of hormones your thyroid should produce.
Likewise, the pituitary gland hormone is controlled by another gland called the hypothalamus, which prompts the pituitary gland into action depending on your body's need for thyroid hormone. The three glands connect through a network called the hypothalamic-pituitary-thyroid axis or HPT axis.
Due to some health situations and other reasons, your thyroid gland can become underactive and hence fail to make enough hormones. Or, it can become overactive, causing it to make excessive hormones.
Such thyroid dysfunctions may lead to two common thyroid conditions, hyperthyroidism and hypothyroidism. 'Hyper' is a prefix meaning excess, while 'hypo' means below normal.
What is Hyperthyroidism?
Hyperthyroidism occurs due to the thyroid gland producing and secreting excessive thyroid hormones. When that happens, the metabolism in the body cells and organs increases, a state called hypermetabolic.
What Causes Hyperthyroidism?
There are various causes of hyperthyroidism. Some of them are:
Graves' Disease. Grave's disease is the primary cause of hyperthyroidism. It is an autoimmune health condition.
The immune system makes antibodies that interfere with pituitary hormones, which regulate thyroid hormone production. With the Graves' disease, your thyroid gland would then start to produce excess hormones to cause hyperthyroidism.
Thyroiditis. Thyroiditis is a health condition of the thyroid gland becoming inflamed. It can lead to either under-production or overproduction of the thyroid hormone. Thyroiditis has three phases, thyrotoxic, hypothyroid, and euthyroid.
It is during the thyroid inflammation in the thyrotoxic phase that it secretes hormones excessively, causing hyperthyroidism.
Toxic Adenomas. Toxic adenoma, a virulent thyroid nodule, is a growth in the thyroid gland. The toxic adenoma, a common condition in senior adults, is usually a non-cancerous (benign) nodule. It can produce excess thyroid hormones leading to hyperthyroidism.
Iodine. Exposure to excess iodine in a patient of the euthyroid phase of thyroiditis condition can lead to iodine-induced hyperthyroidism. Iodine is an essential ingredient in the formation of T4 and T3 thyroid hormones.
Some medicines and foods may contain excess iodine, which would then lead to hyperthyroidism.
Thyroid Medicine. Excess than required use of synthetic thyroid hormone in the treatment of hypothyroidism can lead to hyperthyroidism.
Symptoms of Hyperthyroidism
The most common hyperthyroidism symptoms include:
- Rapid heart rate (more than 100 heartbeats per minute) or irregular heartbeat
- Heart pounding
- Nervousness, irritability, restlessness, and anxiety
- Hand or finger tremors
- Increased blood pressure
- Increased appetite
- Low weight despite high appetite
- High heat sensitivity
- Sweating excessively
- Frequent bowel movement, more than normal
- Fatigue and muscle weakness
- Irregular menstrual cycles
- Thyroid gland swelling (goiter) either symmetrical or one side
- Brittle, fine hair, or hair loss
- Skin thinning
- Sleeping difficulty
- Difficulty in concentrating
- Development of breasts in men
Another typical type of thyroid disease is hypothyroidism.
What is Hypothyroidism?
Hypothyroidism is an underactive thyroid gland that fails to produce the right amount of crucial thyroid hormones, T4 and T3.
Hypothyroidism is prevalent with women age 60 and above. Insufficient thyroid hormones cause slow metabolism and hence low energy.
What Causes Hypothyroidism?
Hashimoto's Thyroiditis. One of the causes of hypothyroidism and the most common is Hashimoto's thyroiditis. It is an autoimmune disorder that can cause thyroid gland inflammation.
With the case of Hashimoto's disease, the immune system releases some antibodies that can attack and ruin your thyroid gland's functions.
It is not clear what leads to autoimmunity in Hashimoto's disease. Scientists assume that genes and some environmental factors may trigger the autoimmunity. Such triggers would then affect the secretion of the thyroid hormone.
Dysfunctional Pituitary Gland. As you may have read earlier, the pituitary gland balances and controls the thyroid hormone's secretion. However, any injury or a health condition affecting the pituitary gland may interfere with thyroid hormone production regulation.
Antithyroid Medications. Hyperthyroidism treatment with antithyroid medications can be over prescribed. Besides stabilizing hyperthyroidism, the excessive use of antithyroid drugs can inhibit or reduce thyroid hormone production leading to hypothyroidism.
Other medications, such as lithium for psychiatric treatment, can affect your thyroid gland and contribute to hypothyroidism.
Thyroid Gland Surgery. A surgery performed by removing even a small part of your thyroid gland can interfere with sufficient hormone secretion, causing hypothyroidism.
Radiation Treatment. Head or neck cancer patient receives radiation therapy on the thyroid gland area. The treatment can damage the gland to lower the production of the thyroid hormone.
What are the Symptoms of Hypothyroidism?
Hypothyroidism symptoms may vary with the level of thyroid hormone deficiency. Hypothyroidism may also not reveal any signs in the early stages of its onset, hence posing diagnosing challenges.
Signs and symptoms of hypothyroidism may include:
- Unexplainable fatigue
- Weight gain
- Blood cholesterol increase
- Slow heartbeat
- Having Chills, sensitive to being cold
- Weak muscle, aches, stiffness, and tenderness
- Hoarse voice
- Dry skin
- Puffy face
- Irregular and heavier menstruation
- Impaired memory
- Stiff, swollen, and painful joints
- Hair thinning
- Swollen thyroid gland (goiter)
Other Thyroid Diseases
Other Thyroid diseases associated with either hyperthyroidism or hypothyroidism include:
Graves' Disease. Graves' disease, which is a common cause of hyperthyroidism, is an autoimmune disorder. The immune system in Graves' disease produces antibodies that attack some healthy thyroid cells. The thyroid cell destruction can cause overproduction of thyroid hormones.
Although we know little concerning Graves' disease, we are sure that autoimmunity can be inherited. Graves' ophthalmopathy is a condition that can accompany Graves' disease.
Graves' ophthalmopathy, also called thyroid eye disease, is an inflammatory eye disease resulting from inflammation and autoimmunity. It affects the eyes and some tissue around it to cause bulging eyes.
Some Graves' ophthalmopathy common symptoms are bulging eyes, puffy eyelids, painful eyes, and light sensitivity.
Thyroiditis. Thyroiditis is a health condition that leads to inflammation and swelling of the thyroid gland. The disease also can influence low or high thyroid hormone production.
Thyroiditis progresses in three stages:
Thyrotoxicosis - Thyrotoxicosis is a condition of excess thyroid hormones in the blood irrespective of the amount the thyroid gland produces. The flip side of such a disorder is high thyroid-stimulating hormone production by the pituitary gland to inhibit thyroid production.
Hypothyroid - Hypothyroid is the stage where the thyroid gland has low hormone production after stage one's overproduction and the pituitary gland regulation.
Euthyroid - it is the phase that is neither thyrotoxic nor hypothyroid. The thyroid produces normal levels of hormones. The euthyroid can also occur after thyrotoxicosis temporarily before progressing to hypothyroid. It may also be the third stage after inflammation recovery showing a maintained hormone level balance.
Some of the thyroiditis symptoms are; fatigue, swelling around the thyroid, irritability, increased appetite, weight loss, and fast heartbeat. However, the symptoms may change depending on the overactive or underactive thyroid gland.
Hashimoto's Disease. Hashimoto's disease is an autoimmune condition where the immune system fights your thyroid cells.
The disease can cause inflammation to the thyroid gland leading to hypothyroidism. Hashimoto's disease is the most common cause of hypothyroidism. It slowly damages the thyroid to reduce thyroid hormone production gradually.
Some of Hashimoto's disease symptoms are fatigue, brittle nails. Hair loss, puffy face, weight loss, severe cold sensitivity, muscle stiffness, and depression.
Thyroid Nodule. A thyroid nodule is an unusual growth within the thyroid gland, which might form a lump. Most of the thyroid nodule cases are asymptomatic (no symptoms) and may be difficult to diagnose.
Your doctor may stumble on it sometimes while performing a physical neck examination or a specific neck imaging procedure. But, your doctor can feel or see the lump if it is large enough or when it grows on a strategic area of the gland.
Most thyroid nodules are cystic, which means they are fluid-filled and not solid or containing tissue. Although thyroid nodules can cause alarm due to malignant (cancerous) possibility, 95 percent of them are benign (non-cancerous).
Goiter. Goiter is a thyroid gland condition where the gland grows abnormally large.
When your thyroid gland cannot secrete enough hormones for body metabolism and other activities, it enlarges while trying to make up for less hormone production and shortage.
Another causing factor for goiter is insufficient iodine in your diet. You may not be facing challenges in maintaining your iodine level in your body. However, some diets in other regions have low iodine leading to goiter.
The difference between goiter and thyroid nodule is an enlarged thyroid gland, while the nodules are growths in the gland.
Some of the goiter symptoms are; a neck swelling below your Adam's apple, hoarseness, and swallowing difficulties.
Thyroid Cancer. Thyroid cancer is a cancer type that affects the cells of the thyroid gland. It develops when the normal cells mutate or change to form abnormal cells. The abnormal cells would then start to multiply and later create a tumor.
Thyroid cancer is treatable if the treatment begins immediately after an early diagnosis.
Some of the thyroid cancer symptoms are:
- A painless neck swelling or lump
- Chronic sore throat
- Chronic hoarseness
- Swallowing difficulty
Other thyroid diseases, such as thyroid nodules, can have similar symptoms. It would always be safe to get the right diagnosis. If you test for thyroid cancer, early treatment would be inevitable to prevent severity and fatality.
Childhood Thyroid Disease. It is heartbreaking to know that children are also susceptible to thyroid diseases. They too are at risk of thyroid disorders such as:
- Thyroid nodules
- Thyroid cancer
What causes thyroid disorder in infants or children?
Some of the causing factors of neonatal thyroid disorders are:
- An underdeveloped or thyroid gland defect.
- A defect pituitary gland that can fail to stimulate or regulate thyroid hormone production.
- Neonatal Graves' disease can pass from the mother to the unborn child when the antibodies cross to the thyroid gland through the placenta.
- Poorly formed thyroid hormones
Infant's Thyroid Disease Symptoms
If your pediatrician failed to notice any thyroid disease signs during the newborn routine screening, you might see the following symptoms:
- Hoarse cry
- Puffy face or eyes
- Distended stomach
- A thick and large tongue
An untreated thyroid disorder in a baby can lead to other complications such as mental defects, heart problems, and neurological issues.
During pregnancy, it is essential to inform your doctor whether some thyroid issues run in your family. The doctor can then know how to prevent you from passing the same to your child.
Diagnosing Thyroid Disease
If not for specific thyroid disease, doctors may find it challenging to diagnose general thyroid disease because of the varying symptoms. However, using more complex diagnosing procedures would distinguish some intricate symptoms on specific thyroid disease.
Such diagnosing procedures include:
Physical Exam. The initial diagnosing process would be a physical exam. Your physician would feel your neck to find whether there are growths or any enlargement in the thyroid gland. It is a simple procedure that would only take a few minutes to deduce the thyroid gland's condition.
An examination of your face and eyes would also be necessary to check for any signs relating to thyroid ophthalmopathy. Your medical person may check for eyes puffiness or bulges, dry eyes, a prominent stare, and the loss of outer eyebrows.
Your doctor can further use a stethoscope to listen to your thyroid gland for increased blood flow, an indication of Hashimoto's, hypothyroid, or thyroiditis disease.
Questioning. Besides the physical examination, your doctor may ask various questions to know more about your health history, such as a former disease associated with thyroid disease. Also, your family history would be crucial while diagnosing thyroid disease to know its origin.
Blood Tests. Blood testing is a definitive way of diagnosing any thyroid disease. The following blood tests would be necessary to identify your thyroid gland's performance by the number of thyroid hormones in your blood.
Blood is drawn from a vein of the inner side of your elbow for blood testing.
Your doctor may require some blood samples to diagnose the following disorders:
Thyroid Hormones. T4 and T3 hormones blood tests would determine whether you have hyperthyroidism or hypothyroidism. High levels of thyroid hormones indicate hyperthyroidism, while low hormones would be hypothyroidism.
The test would also determine how well your thyroid gland is functioning. The test can combine T4, T3, and TSH (thyroid-stimulating hormone) blood tests for further diagnosis.
Thyroid-Stimulating Hormone (TSH). As mentioned earlier, the pituitary gland regulates the number of thyroid hormones your thyroid gland should produce. The pituitary gland hormone (thyroid-stimulating hormone - TSH) production is the reverse of thyroid hormone production.
Less TSH would mean an overactive thyroid gland, and more TSH would mean an underactive thyroid gland.
Therefore, while checking for thyroid hormone imbalance, it would be easy to test the thyroid-stimulating hormone in the blood.
Thyroid-stimulating Immunoglobulin (TSI). As shown from the above blood tests, thyroid-stimulating immunoglobulin (TSI) would be the next blood test if you have hyperthyroidism. The test would be to check for the presence of Graves' disease.
The test measures the level of thyroid-stimulating immunoglobulin in your blood. High amounts of TSI would determine the existence of Graves' disease, which is an autoimmune disease.
Graves' disease prompts the immune system to produce high amounts of TSI antibodies. TSI, in the case of Graves' disease, acts like pituitary gland hormone (TSH). TSI signals your thyroid gland to produce more hormones, which would then result in hyperthyroidism.
Imaging Tests. During your physical examination, your doctor may detect some nodules or thyroid enlargement. For such thyroid conditions, you may need to undergo various imaging tests to diagnose your thyroid condition further. Some of the imaging tests are:
MRI (Magnetic Resonance Imaging). When your doctor suspects that your thyroid has enlarged, an MRI test is necessary to show your thyroid gland's real shape and size.
Thyroid Ultrasound. Thyroid ultrasound is necessary, especially if your doctor needs to evaluate the lumps, nodules, and thyroid gland enlargement. It is also the choice test to determine whether the nodule is cystic or solid.
Computerized Tomography (CT) Scan. The CT scan, in combination with a series of X-ray images, would process cross-section images of your thyroid gland for detailed diagnosis. The test is essential while diagnosing thyroid's larger nodules or goiter.
Nuclear Scan or Radioactive Iodine Uptake (RAI-U). The RAI-U test can differentiate whether you have Graves' disease, thyroiditis, or a toxic multinodular goiter. However, RAI-U is not a suitable diagnostic test if you are pregnant.
There are several other tests your doctor may choose to use while diagnosing your thyroid disease. It would depend on the initial physical examination and other findings from various previous tests. You are free to discuss with your doctor and find out what test is suitable for your condition.
If your thyroid disease is a nodule type, you need to have regular checkups even after treatment. It is essential to arrange with your doctor for such.
Biopsy. While we know that, of all thyroid nodules, 95 percent are benign or non-cancerous. Your doctor may be suspicious of any thyroid nodule or lump. A biopsy test would clear such doubts to reveal whether the lump or nodule is benign or cancerous.
For a needle biopsy, a lab technician would withdraw some cells from the thyroid nodule using a thin needle. For a precise biopsy, the technician may use an ultrasound to direct the needle to the right place.
Thyroid Disease Treatment
The aim of treating thyroid disease is to stabilize and manage the thyroid hormone levels. Therefore, the treatment for thyroid disease would vary greatly depending on each thyroid disease.
The following is the treatment for hyperthyroidism which aims to lower the levels of the thyroid hormones:
The medications that would reduce thyroid hormones production are:
Anti-thyroid drugs - Propylthiouracil or methimazole. The two are prescription medicines that only your doctor has an authority to allow using them. The medication inhibits and manages thyroglobulin from forming T4 and T3 and their activity.
You may need to ask your doctor about the side effects while using either of the two medicines and the dangers of interactions with other medications you might currently be using.
Radioactive Iodine - Some doctors may prescribe this type of medication, although not the best option when treating a typical thyroid disease case such as thyroid nodules. Radioactive iodine (RAI) is often used to destroy the thyroid gland and hence irreversible.
You may hear your doctor mentioning radioiodine ablation while discussing the treatment. It means destroying part or the entire thyroid gland. Discuss with your doctor on radiation effects on you and the people around before opting for RAI therapy.
Beta-blockers - Beta-blockers are not for treating hyperthyroidism. The medications are for improving hyperthyroidism symptoms to reduce the effect of excess thyroid hormone on your heart.
Surgery - If your thyroid is beyond getting better even after using medicines, your doctor may opt to remove it, a procedure medically known as thyroidectomy surgically. Surgical therapy is a permanent solution for your thyroid treatment, similar to RAI.
Different Types of Thyroidectomy - Depending on your lump or nodule's severity, your doctor may perform thyroidectomy differently, such as:
Lumpectomy or biopsy - removing just a small part of your thyroid gland
Lobectomy - Removing almost half of the thyroid gland
Subtotal thyroidectomy - Removing virtually the entire thyroid tissue and leaving a bit of it on both sides of the gland.
Near-total thyroidectomy - Removing almost the entire thyroid tissue and leaving a bit of it on one side.
Total thyroidectomy - Removing the entire thyroid gland.
How is Thyroidectomy Performed? Thyroidectomy procedure has two ways of performing it:
- Old standard surgery of front neck incision
- New armpit incision
There are many factors to consider while performing incision. Your doctor may discuss the right procedure to use in your case.
While the traditional front neck incision surgery leaves a prominent scar across your neck, it is less complicated.
The armpit incision for thyroidectomy is new and hence might be a complicated procedure. However, it is safe with minimal dissection field, little or no postoperative pain, and a minimal hidden scar, which adds to your cosmetic satisfaction.
Remember, your metabolism and other body activities would still require thyroid hormone even after going through thyroidectomy. Therefore, you will need to replace hormone production by using thyroid hormone replacement medicines for the rest of your life.
Thyroid replacement medication is what you may need for your hypothyroidism case to increase your thyroid hormone. The standard medicine for hypothyroidism is levothyroxine, which restores enough hormone levels.
The medication would increase your hormone levels and reverse the hypothyroidism symptoms such as weight gain and other symptoms, as we mentioned earlier on.
Your doctor may further advise you on the use of levothyroxine and your diet while using the drug. Also, since it is a lifelong medication, you may have to schedule a yearly checkup or, as your doctor directs you. Such an arrangement would monitor the thyroid hormone level in your blood.
Thyroid Disease Complications
If you delay seeking treatment for your thyroid disease or if your condition is severe, you may be at risk of other complications such as adverse health conditions.
- Mental health
- Heart problems
- Skin problems
- Congenital disabilities
- Heart problems such as arrhythmia
- Osteoporosis (brittle bones)
- Skin problems such as Graves' dermopathy
- Graves' ophthalmopathy
- Thyrotoxic crisis or severe symptoms
Thyroid Disease Complementary and Alternative Therapy
There are various alternative treatments for heart health issues. However, you may require consulting your health practitioner for the best therapy and advice. The following are some of the recommendations from our natural health practitioner, Yvonne Dollar Perc.
At Island Healthworks, we do Live Blood Analysis and look at dry blood samples specifically.
Observed in Layer(s):
Light pinkish-white patches that do not have any black lines occurring just inside the edge of the sample. May imply a range of potential thyroid imbalances.
The following are our recommendations for a healthy thyroid.
Kelp, 100 Capsules - Kelp, commonly known as seaweed, is botanically classified as algae. It is a source of vitamins and minerals, including essential trace minerals, and especially high in iodine, which must be present for the proper functioning of the thyroid gland and metabolism. Kelp is a traditional food still enjoyed today and is an important source of the mineral iodine, especially for maritime cultures.
TS II (100 Caps) - TS II is a formula designed to support the glandular system, especially the thyroid gland. TS II contains kelp plant, Irish moss plant, parsley plant, hops flower, and capsicum fruit. Kelp contains an above-average amount of iodine, which is a nutrient essential for proper thyroid function.
KC-X (100 Caps) Combination Herb - KC-X contains kelp, which is a source of iodine and nutritionally supports thyroid function and prevents iodine deficiency. Supportive herbs in this combination are Irish moss plant, black walnut hulls, parsley herb, and sarsaparilla root.
It might be challenging to prevent yourself from getting thyroid disease. However, you can arrest the complications by knowing about your condition early enough through regular thyroid checkups.
If your doctor detects any anomaly in your thyroid gland, you may go through further tests to ascertain the condition. Treatment would then ensue almost immediately.
You don't need to hesitate for such quality testing. Please book for your thyroid checkup or other general and routine checkups without delay. We can discuss with you the best natural therapies for your thyroid condition. The sooner we do this, the better, to prevent complications.
Do you know that you can get FREE virtual health consultation?
Yes, our Natural Health Practitioner and Master Herbalist, Yvonne, can do that for absolutely FREE. All we ask you to do is answer our health questionnaire, and she will contact you to discuss the way forward. It is an online consultation that you can have while sitting at your house or office. Try it out!
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This article is intended for educational purposes and the information contained within is not intended to treat, diagnose or cure any disease or health problem. Please seek appropriate medical attention for any health complaints. We cannot take responsibility for your health care decisions. Our intent is only to offer health information to help you with your search for better health.