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8 Frequently Asked Questions About Your Thyroid

FAQs About Thyroids

Even though this tiny, butterfly-shaped gland keeps our bodies functioning properly every day, most of us don’t even realize it exists. January is Thyroid Awareness Month so it’s a great time to learn more about this frequently overlooked part of the body.

1. What is the Thyroid?

The thyroid is a small, butterfly-shaped gland located at the front of the neck along your windpipe. Weighing less than an ounce, this gland is responsible for regulating your metabolism – the rate at which your cells use energy and produce heat.

If your thyroid malfunctions, virtually every cell in your body will be affected. Thyroid hormones impact everything from breathing, heart rate, and body temperature to digestion, muscle contraction, and more. “As tiny as it is, the thyroid affects organs throughout your system, from hair and nails to heart, colon, and brain,” says Dr. Ana Cornea, endocrinologist with Parkridge Health System – Diagnostic Center.

2. How does it work?

The thyroid uses iodine from the foods you eat to make two hormones: tyroxine (T4) and triiodothyronine (T3). Together, these hormones work to control metabolism. The thyroid gland produces about 80% T4 and 20% T3. If levels of either is too high or too low, you will suffer from a thyroid disorder.

The hypothalamus and the pituitary gland in the brain are responsible for keeping watch over thyroid levels and making sure they stay balanced. If the hypothalamus detects your blood thyroid levels are too low, it will produce thyrotropin-releasing hormone (TRH) to stimulate the pituitary gland to produce thyroid-stimulating hormone (TSH). TSH, in turn, encourages your thyroid to release more T3 and T4. Conversely, if the hypothalamus detects your blood thyroid levels are too high, it will release less TRH, which will in turn decrease production of TSH, and consequently, T3 and T4. 

3. What are the symptoms of a thyroid disorder?

Hyperthyroidism is when the thyroid gland is overactive, or produces excessive levels of thyroid hormones (hyper means “over” or “above normal”). Common symptoms include heart palpitations, weight loss, intense anxiety, an enlarged thyroid, increased appetite, tremors in the hands and fingers, sweating, and menstrual changes.

Hypothyroidism is when the thyroid gland is underactive, or does not produce sufficient levels of thyroid hormones (hypo means “under” or “below normal”). Common symptoms include fatigue, difficulty concentrating, cold sensitivity, headaches, joint pain, dry skin, constipation, menstrual irregularities, and depression.

Keep in mind that thyroid disorder symptoms tend to be subtle and develop gradually. Additionally, symptoms are non-specific – meaning, they affect the whole body as opposed to one particular body part – this is why thyroid disorders frequently go undetected.

4. How prevalent are thyroid disorders?

Thyroid disorders are more common than you’d think. More than 12% of people in the United States will develop a thyroid condition in their lifetime, according to the American Thyroid Association. This amounts to roughly 20 million Americans, 60% of which are completely unaware of their condition.

5. What factors increase the risk of a thyroid disorder?

If you are reading this and you are a male, thank your lucky stars because women are 5 to 8 times more likely to develop thyroid disease. The reasons for this gender disparity aren’t known. However, some researchers attribute it to changes that occur in the immune system during pregnancy and delivery.

Other risk factors include age – people over 60 are more at risk to develop thyroid disease – and having a family history of thyroid disease or autoimmune disease. “Autoimmune thyroid diseases like Grave’s disease and Hashimoto’s disease tend to cluster in families,” says Dr. Asma Khan, endocrinologist with Academic Endocrinology at Erlanger.

More than 12% of people in the United States will develop a thyroid condition in their lifetime, according to the American Thyroid Association.

6. When should you get your thryoid levels checked?

Sometimes, routine bloodwork will include screening for thyroid disease. However, in most cases thyroid levels are only checked when a person has symptoms or a family history of thyroid disease or autoimmune disease.

The good news is, diagnosing thyroid disease is easy. Your primary care physician or endocrinologist will begin by reviewing your symptoms, medical and family history, and risk factors. He or she will then conduct a physical exam.

If your symptoms and health profile warrant further testing, your doctor will order blood tests to check your thyroid hormone levels. “In most cases, a doctor will only run one test – TSH,” says Dr. Khan. “TSH is the most sensitive test of thyroid function. Unless TSH is abnormal there is usually no need to continue testing.”

In some incidences, a doctor may also test levels of the thyroid hormone thyroxine (T4). If this test result also comes back normal, you can be confident your thyroid is functioning correctly. “If you have normal TSH and T4, you can rest assured that you do not have a functional thyroid disorder,” says Dr. Cornea.

7. How do you keep your thyroid healthy?

While it’s always a good idea to exercise, keep a healthy weight, and manage stress, to maintain overall good health, these factors typically do not have a direct effect on your thyroid.

One lifestyle factor that can directly affect your thyroid, however, is your iodine consumption. Since the thyroid relies on iodine to produce T3 and T4, regular iodine consumption is critical for thyroid health. A century ago, iodine deficiency was a common problem in the U.S. – and it continues to be an issue worldwide. However, thanks to the introduction of iodized salt and fortified flours in the 1920s, iodine deficiency is typically no longer an issue in the Western World.

“Unless someone isn’t eating any salt or bread products, or is confining themselves to foods made with exotic salts like sea salt, it’s not a problem anymore,” says Dr. Khan.

To ensure your body gets its daily 150 mcg (micrograms) of iodine it needs to keep your thyroid healthy, fill up on fish, dairy products, healthy fats, and eggs. Also, be wary of taking an iodine supplement unless it has been specifically recommended by your doctor. Your body is already getting all the iodine it needs through food. “Be on guard against claims made by iodine supplements,” says Dr. Cornea. “We typically do not see iodine deficiency in this country. Taking iodine supplements can actually have an adverse effect on your thyroid function.”

Doctor Checking woman's thyroid

8. Can thyroid disorders cause weight gain?

The short answer is: yes and no. The relationship between your weight and your thyroid is complex. While it’s true that an overactive thyroid (hyperthyroidism) is associated with weight loss and an underactive thyroid (hypothyroidism) is associated with weight gain, it’s far too easy to blame your thyroid for the numbers on the scale.

If you’ve gained more than 10 pounds of unwanted weight, the issue is probably farther reaching than your thyroid. “Hypothyroidism sufferers typically gain 6 to 10 pounds of water weight due to fluid retention, and this goes away when corrected,” explains Dr. Cornea. “However, you don’t typically see any more than this.”

Bottom line: if you’ve been struggling to lose weight, your thyroid levels could be worth checking. However, if your numbers come back normal, be wary about asking for thyroid medication. For one, it won’t help you lose weight. But beyond that, it can put your health at significant risk. “Taking thyroid medication when you don’t need it is a very dangerous thing. It’s very bad for the heart and bones,” says Dr. Khan. “There are so many misconceptions out there about the thyroid. If there is one thing I would love people to understand it is that you can’t use thyroid medications to lose weight or gain more energy.”

Dr. Ana Cornea

Dr. Ana Cornea

Endocrinologist, Parkridge Health System – Diagnostic Center

Dr. Asma Khan

Dr. Asma Khan

Endocrinologist, Academic Endocrinology at Erlanger

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