(And Why It’s So Misunderstood)
With vague symptoms like feeling tired or cold, it’s no wonder a thyroid disorder is often a suspect in many health problems.
These symptoms, which may indicate hypothyroidism, are nonspecific and overlap with multiple other conditions. So while it’s important to evaluate thyroid function in anyone who has these symptoms, your thyroid is not always to blame.
“If your thyroid labs are normal, specifically the thyroid stimulating hormone (TSH), then in a vast majority of cases your thyroid is not causing your symptoms,” explains Northwestern Medicine Endocrinologist Eve D. Bloomgarden, MD. Dr. Bloomgarden and Anna V. Balabanova, MD, a family physician at Northwestern Medicine Osher Center for Integrative Medicine, share why the thyroid is often misunderstood and address some myths about your thyroid.
A Look at the Thyroid
The thyroid gland is a butterfly-shaped gland located in the front of your neck that makes and secretes thyroid hormones. It is regulated by the pituitary gland, and is dependent on iodine intake from your diet.
“Thyroid hormones secreted from the thyroid gland affect function in virtually all parts of the body, and it is essential for normal function to have a constant supply of thyroid hormone available. The body does this very elegantly, but it’s no wonder that the list of thyroid symptoms is lengthy,” says Dr. Bloomgarden.
Here are seven more facts you should know about your thyroid.
- Thyroid stimulating hormone (TSH) blood tests are really accurate.
- Women are more likely than men to have thyroid issues.
- Most thyroid disorders can’t be prevented.
- Stress and other factors can worsen thyroid disorders.
- Thyroid disorders need to be addressed before and during pregnancy.
- Thyroid disorders should be managed.
- Certain myths can be dangerous to your health.
The TSH test is a blood test that is used to screen for thyroid dysfunction. “Many people don't realize a general thyroid function screen actually tests the thyroid stimulating hormone as opposed to the actual amount of thyroid hormones. In general, this is a great measure of how the overall thyroid hormone system is functioning,” says Dr. Balabanova.
Even small changes in your thyroid hormone levels (T4 and T3) will cause very big changes in TSH secretion. If your thyroid is unable to make enough thyroid hormone (hypothyroidism), your TSH will rise quickly and remain elevated. If your thyroid is making too much thyroid hormone (hyperthyroidism), your TSH will drop to zero. Therefore, the most appropriate test to screen for thyroid dysfunction in the vast majority of cases is a TSH blood test.
“The TSH test is really accurate. Other lab tests for thyroid function are supplemental and may not be clinically relevant or appropriate,” adds Dr. Bloomgarden.
One in eight women will develop thyroid problems during her lifetime, particularly after pregnancy and during menopause. The most common thyroid condition is hypothyroidism. Some symptoms include fatigue, feeling cold, muscle weakness and unexplained weight gain.
There is no way to cure autoimmune thyroid disease or slow the progression of thyroid disease, but if you are one of the 20 million Americans affected, you can take actions to manage the condition. Dr. Bloomgarden says that thyroid disease will take its natural course. Your best bet is to get a diagnosis, prevent it from becoming a significant problem, and take measures to minimize its impact on your body and your life.
Managing overall health can minimize the impact of symptoms.
“Factors like illness, pregnancy and stress can impact thyroid function,” Dr. Balabanova says. “We always work with patients on tailoring personalized, specific stress management strategies and decreasing overall inflammatory processes.”
Incorporating exercise into your daily routine and maintaining healthy relationships can help your thyroid, too. Rest is also important, and you should be getting seven to nine hours of sleep each night. This can be tricky if you have a thyroid disorder because it can impact sleep. Strategies to improve your sleep include following a sleep-wake routine, limiting your exposure to light by avoiding scrolling through your phone before bed or watching TV, and avoiding caffeine and exercise before bedtime.
Thyroid hormones are imperative to help provide an environment for your baby to thrive during development, particularly during the first three months. For that reason, if you have a pre-existing thyroid condition, it’s important to monitor hormone levels before and during your pregnancy.
“There is a specific TSH level that we are looking to see prior to pregnancy,” says Dr. Bloomgarden. “We monitor levels much more closely during pregnancy to ensure adequate thyroid hormone availability to the baby.”
Abnormal thyroid hormone levels can cause serious health effects, so managing your thyroid disorder is very important. If you have a thyroid disorder it should be treated using evidence-based guidelines and prescription medication, says Dr. Bloomgarden. “We have a number of thyroid hormone preparations that are FDA-regulated, safe, effective and well tolerated,” she says.
“At the Osher Center, we try to support the body's innate ability to heal itself as much as possible. Sometimes we'll recommend supplements, which have been shown in research to be promising for certain patients,” says Dr. Balabanova.
However, Dr. Balabanova adds, “It's important to consult with a physician before starting any supplement.” As with any supplement, these products can be dangerous when taken in high amounts or without regular monitoring by your physician. Improper use of supplements can cause conditions ranging from nausea and diarrhea to serious kidney problems or nerve damage.
With an overwhelming abundance of information available online, it’s becoming increasingly difficult to figure out what’s true. “Certain products advertised as thyroid boosters can actually be quite harmful,” says Dr. Bloomgarden. “I want my patients to feel well and not let thyroid disease define them, so I spend a lot of time dispelling myths and encourage them to ask questions at follow-up visits.”