The Truth About Thyroid Disease
Addressing 10 Commons Myths
Researchers estimate that roughly 20 million Americans are living with thyroid disease, but roughly 60% are unaware of their condition. This could be due to a general lack of awareness, but there is also a wealth of conflicting information available online – often from questionable sources. Here, we separate fact from fiction and share helpful information from Dr. Prashanth Sekhar, an endocrinologist with CHI Memorial Endocrinology Associates.
What is Thyroid Disease?
The thyroid is a gland that produces thyroid hormone, which is responsible for regulating the body’s metabolism. Thyroid disease is an umbrella term for hormone imbalances that occur when the thyroid is not functioning properly, causing either hyperthyroidism or hypothyroidism.
Hyperthyroidism
Hyperthyroidism occurs when the thyroid creates too much thyroid hormone, causing the body to burn through energy too quickly. The most common cause of hyperthyroidism is Gravesʼ disease, an autoimmune disorder that attacks the thyroid. It can also be caused by overactive thyroid nodules, thyroiditis, taking too much thyroid hormone, or excessive amounts of iodine in the body in rare cases.
Symptoms include:
- Fatigue
- Sensitivity to heat
- Weight loss
- Tremors
- Anxiety
- Difficulty concentrating
- Frequent bowel movements
- Increased appetite
- Changes to nails, hair, or skin
- Pounding or racing heartbeat
Hypothyroidism
With hypothyroidism, the thyroid is unable to produce enough thyroid hormone, which limits the body’s ability to convert food into energy. The most common cause of hypothyroidism is Hashimoto’s disease, an autoimmune disorder that attacks the thyroid. Sometimes, in cases of severe hyperthyroidism or thyroid cancer, surgery to remove all of part of the thyroid can also leave people with hypothyroidism. Additional causes include thyroiditis, certain medications, and iodine deficiency, though this is very rare in the United States thanks to iodine additives in things like table salt.
Symptoms include:
- Fatigue
- Sensitivity to cold
- Mild weight gain
- Depression
- Dry skin
- Muscle aches or weakness
- Constipation
- Thinning or coarse hair
- Slowed heart rate
- Difficulty with memory
Myth: You shouldn’t eat cruciferous vegetables if you have hypothyroidism.
Truth: Cruciferous vegetables, like broccoli, cauliflower, Brussels sprouts, and kale, were once thought to impede the thyroid’s ability to utilize iodine, which is necessary for thyroid hormone production. However, a person would have to eat an unrealistic portion of these vegetables every day for this to be true, and they are recommended as part of a balanced diet.
Myth: Hypothyroidism causes significant weight gain and makes losing weight very difficult.
Truth: Depending on the severity, hypothyroidism may result in a mild increase of five to ten pounds, but the thyroid is very rarely responsible for more significant gains. Furthermore, proper treatment should eliminate any troubles. “As long as their levels are in the normal range, it should not be affecting any issues with weight,” says Dr. Sekhar. “When a patient has difficulty with weight, the two biggest factors tend to be diet and exercise.”
Myth: Nodules, or lumps, on the thyroid are a clear sign of thyroid cancer.
Truth: Nodules are typically benign, with only a small percentage being cancerous. However, Dr. Sekhar recommends, “If you have risk factors for thyroid cancer, for example, a first-degree relative with thyroid cancer, then it’s important to also be evaluated by a primary care physician.”
Myth: Having a fast metabolism just means you get to eat more food.
Truth: Hyperthyroidism can lead to a variety of health complications and should not be taken lightly. “If we let even a mildly overactive thyroid go untreated, depending on the patient’s age, it can increase the risk for cardiovascular disease,” Dr. Sekhar shares. “Hyperthyroidism can increase their cholesterol and cause heart dysfunction. It can also increase their risk of fatty liver disease, atrial fibrillation, and stroke, or decrease bone mineralization and lead to osteopenia or osteoporosis.”
Myth: Only women who are middle-aged or older develop thyroid disease.
Truth: Women are at significantly higher risk of thyroid disease than men and the risk does increase with age, but thyroid disease can affect anyone – especially people who have another autoimmune disorder such as type 1 diabetes, lupus, or celiac disease. Anyone taking medications with a high iodine content should also be aware that this increases their risk of thyroid dysfunction.
Myth: Vague or mild symptoms of thyroid disease are nothing to worry about.
Truth: Untreated thyroid disease can cause severe complications, so it is best not to ignore potential warning signs. “The symptoms can be very non-specific because there are a lot of conditions that can mimic symptoms of either an overactive or underactive thyroid. We usually rely on blood tests or lab work to evaluate for these disorders, so the first thing I would recommend is seeing your primary care doctor for lab work if you have any symptoms related to thyroid disease,” says Dr. Sekhar.
Myth: Everyone with hypothyroidism should be on a gluten-free diet.
Truth: There is no conclusive evidence that gluten has any impact on thyroid disorders alone. However, if a person also has celiac disease, ingesting gluten could damage the small intestine and interrupt the absorption of replacement thyroid hormones. Having celiac disease increases the risk of developing autoimmune thyroiditis and vice versa, so it is best to be evaluated if you have one or the other.
Myth: Thyroid support supplements are an effective way to prevent or treat thyroid disease.
Truth: Though many “thyroid support” supplements claim to aid in weight loss and improve energy levels, they are not regulated by the FDA and may do more harm than good, according to Dr. Sekhar. “I typically don’t recommend taking any of these supplements. Some of them contain a lot of iodine or desiccated animal thyroid, which can make things worse,” he explains. “If you have some mild, intrinsic thyroid dysfunction to begin with, these supplements may trigger an overactive thyroid or even an underactive thyroid.”
Myth: Eating a balanced diet will prevent thyroid disease.
Truth: A balanced diet will include the nutrients necessary for proper thyroid function, but that alone is not enough to restore healthy thyroid function for a person who has hypothyroidism or hyperthyroidism. Furthermore, Dr. Sekhar says, “If you have certain risk factors for thyroid disease, such as autoimmune diseases like Hashimoto’s or Gravesʼ disease, there’s nothing you can really do or take to prevent the onset of these conditions.”
Myth: Taking extra thyroid hormones can help you lose weight and feel energized.
Truth: Taking too much thyroid hormone replacement can cause hyperthyroidism, which has its own serious complications. Any changes to how you take these medications should be monitored closely by your doctor. “To determine the right dosage, we don’t just rely on symptoms because these symptoms can be very non-specific,” Dr. Sekhar explains. “I specifically rely on lab work when starting a patient on medication for the thyroid, and I generally repeat their lab work six to eight weeks later to make adjustments if necessary.”
Prashanth Sekhar, MD
Endocrinologist, CHI Memorial Endocrinology Associates
