The thyroid gland, located at the back of the neck below the Adam’s apple, is a gland that produces thyroid hormones. Thyroid hormones regulate our body’s metabolism, as well as helping to regulate energy usage, the use of hormones and vitamins, and the growth and maturation of body tissues. Thyroid disease either creates an overabundance of thyroid hormones, called hyperthyroidism, or too little thyroid hormones, called hypothyroidism. Both of these conditions create unpleasant symptoms, but can be effectively managed after proper diagnosis.
Causes of Thyroid Problems
The “hypothalamus”a part of the brain located just above the brain stem”releases thyrotropin-relasing hormone, or TRH. TRH then travels to the pituitary gland, which is an endocrine gland located at the bottom of the hypothalamus. In response to the presence of TRH, the pituitary gland releases thyroid-stimulating hormone, or TSH, into the blood. The TSH then goes to the thyroid gland, resulting in the thyroid producing two thyroid hormones called L-thyroxine and triiodothyronine. In order to produce these thyroid hormones, dietary iodine must be available to the brain.
The pituitary gland regulates the production of thyroid hormone by sensing how much hormone is in the blood and adjusting the production of hormones as needed. When there is too much thyroid hormone in the blood, the pituitary gland senses this and reduces the amount of TRH and TSH produced until the level of thyroid hormones in the blood returns to normal.
When there is too little thyroid hormone in the blood, the pituitary gland senses this and increases the amount of TRH and TSH produced until the level of thyroid hormones in the blood reaches a normal level. If there is a defect in this thyroid hormone regulatory process, for any reason, hypo- or hyperthyroidism may result.
Causes of Hyperthyroidism
Grave’s Disease: an autoimmune disorder resulting in antibodies stimulating the thyroid and causing too much thyroxine to be released. Antibodies, usually used to protect against viruses, bacteria and foreign substances, attack the thyroid and sometimes the tissues behind the eyes and the skin in the lower legs over the shins. A genetic predisposition appears to be a causal factor of Grave’s Disease.
- Hyper functioning thyroid nodules: the presence noncancerous lumps that form when a part of the thyroid gland walls itself off from the rest of the gland”also called an adenoma”that produce excess thyroxine, thus causing hyperthyroidism. The cause of these adenomas that produce excess thyroxine is unknown.
- Thyroiditis: the inflammation of the thyroid gland, causing excess thyroid hormones to leak into the bloodstream. Some types of thyroiditis cause thyroid gland pain, while others are painless and sometimes occur after pregnancy.
- Autoimmune disease (Hashimoto thyroiditis): an autoimmune disorder resulting in antibodies that attack tissues, affecting the thyroid’s ability to produce hormones.
- Treatment for hyperthyroidism: radioactive iodine or anti-thyroid medications used to treat hyperthyroidism can sometimes result in permanent hypothyroidism.
- Radiation therapy: used to treat cancers of the head and neck, radiation therapy can affect the thyroid gland and lead to hypothyroidism
- Thyroid surgery: the process of removing a large portion or all of the thyroid, resulting in the halting hormone production
- Medications: some, such as lithium, contribute to hypothyroidism
- Congenital disease: birth defect where the thyroid gland did not develop normally in utero
- Pituitary disorder: the failure of the pituitary gland to produce enough TSH, often due to a noncancerous tumor
- Pregnancy: during or after pregnancy some women produce antibodies to their own thyroid gland, resulting in hypothyroidism and putting the pregnancy at risk
- Iodine deficiency: essential for the production of thyroid hormones, the amount of dietary iodine in the body is sometimes too low to assist in the production of thyroid hormones
Many of the symptoms of hyper- and hypothyroidism are uncomfortable and mild. Therefore, thyroid problems are easily overlooked by individuals until they gain in intensity. Symptoms often develop slowly, but as the illness continues untreated the symptoms increase. It is important to know the signs of thyroid problems so medical advice and treatment can be received as soon as possible.
- Sudden weight loss
- Rapid heartbeat (more than 100 beats per minute), irregular heartbeat, or pounding heart
- Increased appetite
- Nervousness, anxiety, irritability
- Tremor, usually in hands and fingers
- Change in menstrual patterns
- Increased sensitivity to heat
- Changes in bowel patterns, especially more frequent occurrence
- Enlarged thyroid gland (goiter), which shows as swelling at the base of the neck
- Fatigue and muscle weakness
- Difficulty sleeping
Additional Symptoms Include:
- Increased sensitivity to cold
- Pale, dry skin
- Puffy face
- Hoarse voice
- Elevated cholesterol level
- Unexplained weight gain
- Muscle aches, tenderness, stiffness
- Pain, stiffness, swelling in joints
- Muscle weakness
- Heavier than normal menstrual periods
- Brittle fingernails and hair
Close attention to symptoms common of thyroid problems is essential in diagnosing such problems. While hypothyroidism generally occurs in middle-aged and older women, it is possible for infants and children to develop hypothyroidism as well. The following should be watched for in case of hypothyroidism in infant or children:
- Jaundice: yellowing of the skin and whites of the eyes
- Frequent choking
- Large, protruding tongue
- Puffy face
- Poor muscle tone
- Excessive sleepiness
- Poor growth
- Delayed permanent teeth
- Delayed puberty
- Poor cognitive development
In addition to the various causes of hypothyroidism, there are certain factors that put people at risk of developing the thyroid disorder. These risk factors include:
- A family history of autoimmune disorders
- Having undergone radioactive iodine treatment or taken anti-thyroid medications
- Having undergone radiation treatment to the neck or upper chest
- Having had thyroid surgery
Testing for Thyroid Disease
If concerned about thyroid problems, a medical doctor should be consulted. A comprehensive exam, including a physical exam, medical history, and blood test, can accurately determine if a thyroid disease is present. The blood test is used to determine the level of thyroid hormones in the blood. A low level of thyroxine and a high level of thyroid-stimulating hormone indicates hypothyroidism; while high levels of thyroxine and a low level of thyroid-stimulating hormone indicates hyperthyroidism.
If blood tests indicate hyperthyroidism, the medical doctor may request one of the following additional tests to determine the cause of the overactive thyroid:
Radioactive iodine uptake test: a small oral dose of radioactive iodine is taken, which collects in your thyroid gland, and is checked after 2, 6 or 24 hours to determine how much iodine the thyroid gland has absorbed. If a high amount of radioiodine has been absorbed, the thyroid gland is producing too much thyroxine and the cause of the hyperthyroidism is most likely Graves disease or hyper functioning nodules. If the amount of radioiodine absorbed is low, the cause of the hyperthyroidism is likely thyroiditis.
Thyroid scan: radioactive isotope is injected into the side of the elbow or hand, and a special camera produces an image of the thyroid on a computer screen.
It is extremely important that these additional tests be done in order to determine the cause of the hyperthyroidism, and to ensure the proper treatment of the disease.
Thyroid Disease Treatment
Thyroid disease is a serious medical problem that has no cure or ways to prevent it from occurring. However, the good news is that thyroid disease can be effectively managed with the proper treatment.
Taken orally, radioactive iodine is absorbed by the thyroid gland causing it to shrink and symptoms of hyperthyroidism to subside. Side effects include slowing thyroid activity to the point where medication may be needed every day to replace thyroxine.
Medications that gradually reduce symptoms of hyperthyroidism by preventing thyroid gland from producing excess hormones. Side effects include liver damage.
Drugs common for treatment of high blood pressure that do not reduce thyroid levels, and which reduce rapid heart rates and prevent palpitations. May be prescribed until thyroid levels are in the normal range.
Removal of most of the thyroid gland. This is used only in rare cases and when anti-thyroid medications cannot be tolerated. Side effects include damage to the vocal cords and parathyroid glands, the need for lifelong treatment to supply body with normal amounts of thyroid hormones, and the need for medication to keep blood-calcium levels normal.
Treatment for hypothyroidism is the prescription of an oral medication that is a synthetic thyroid hormone levothyroxine. This treatment is usually lifelong, though the symptoms of hypothyroidism will begin to alleviate after only a few weeks. This treatment requires a blood test 2 -3 months after beginning oral medication in order to determine TSH levels.
There are virtually no side effects associated with the proper dosage of this medication, though some supplements, medications and foods may interfere with the effectiveness of the medication. The doctor should be made aware of a high soy or fiber diet, as well as medications taken such as iron supplements, Cholestyramine, Aluminum hydroxide (found in antacids), and calcium supplements.
At Home Remedies
There are various at-home remedies believed to assist in the treatment of thyroid disease. However, it is important to note that these herbal and home remedies are not monitored by the FDA and their efficacy cannot be guaranteed. Before choosing these alternatives as treatment, a medical doctor and/or naturopath should be consulted.
- Kelp seaweed: antioxidant containing iodine, which helps in the functioning of the thyroid
- Bladderwack: high in iodine and therefore beneficial for hypothyroidism
- Vitamin B Complex: improves cellular oxygenation and energy, and assists with digestion, immunity and thyroid functioning
- Primrose Oil: essential fatty acid, important for thyroid functioning
- Irish Moss: nourishes the thyroid
- Siberian Ginseng: helps adrenal and thymus glands, which supports thyroid health
- Black walnut: rich in organic iodine and manganese that nourishes and strengthens thyroid function
- Vitamin A rich foods: yellow vegetables, eggs, carrots, and dark green vegetables help in thyroid functioning
In addition to the at-home natural remedies listed above, there are various nutritional supplements available in pill form at organic and naturopathic stores, as well as online. These range in price from $10 – $50 depending on the brand purchased, the store or online retailer purchased from, and the size of the bottle purchased.
As with all issues relating to health, diet and exercise are important factors in the well being of our bodies. Whether pharmaceutical, surgical or at-home remedies are used as treatment for thyroid disorder, a healthy diet and exercise plan can help to increase not only the health of the thyroid, but of the body as whole.