According to the American Thyroid Association (ATA), approximately twenty million people in the United States have a thyroid disorder, and up to 60 percent of these people are unaware of their condition. That’s not completely surprising considering many don’t know what the thyroid is, so let’s begin there: the thyroid is a small, butterfly shaped gland located inside the neck. It is responsible for producing two hormones, thyroxine (T4) and triiodothyronine (T3), which are transmitted into the blood stream to the rest of the body. Thyroid hormones regulate our body’s metabolic function and affect virtually every organ system. Hypothyroidism, or too little thyroid hormones, and hyperthyroidism, too many thyroid hormones, are among the most common thyroid disorders. Both can be dangerous if left untreated, so let’s go into more detail about exactly what they are.
Simply put, hypothyroidism is an under-active thyroid. Meaning, the thyroid does not produce enough thyroid hormones to maintain our body’s metabolic function. Women over fifty are more likely to be affected. The most common cause of hypothyroidism is Hashimoto’s disease, an autoimmune disorder in which the immune system attacks the thyroid, interfering with its ability to produce thyroid hormones. Symptoms of hypothyroidism include:
- Increased sensitivity to cold
- Pale, dry skin
- A puffy face
- Hoarse voice
- Elevated blood cholesterol
- Unexplained weight gain
- Muscle aches
- Joint pain or stiffness
- Muscle weakness
- Heavier than normal menstrual periods
- Brittle fingernails and hair
Consult with your health care provider if you experience any of the symptoms listed above for further evaluation. The most severe form of hypothyroidism is myxedema. Although rare, it can be life threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature and even coma. Other causes of hypothyroidism include surgical removal of the thyroid, radiation treatment, congenital hypothyroidism, viral infections, some medications such as amiodarone and lithium, and too much or too little iodine.
Hyperthyroidism is an over-active thyroid. It is more likely to occur in women than in men, and approximately fifteen percent of recognized cases occur in people over the age of sixty. Due to the excess circulating thyroid hormones, the body’s metabolic function speeds up. The most common cause of hyperthyroidism is Graves’ disease, an autoimmune condition that causes the thyroid gland to produce too many hormones. Graves’ disease is more common in those with a family history of thyroid disorders. Signs and symptoms of hyperthyroidism may include:
- Muscle weakness
- Trembling hands
- Rapid heartbeat
- Weight loss
- Diarrhea or frequent bowel movements
- Irritability and anxiety
- Vision problems
- Bulging eyes
- Menstrual irregularities
- Intolerance to heat and increased sweating
The classic symptoms of hyperthyroidism may be absent in the elderly. Other possible causes of hyperthyroidism include thyroid nodules, or lumps within the thyroid gland, too much thyroid hormone medication, and viral infections. You should consult with your health care provider for any concerning symptoms.
Diagnosing thyroid disorders begins with a visit to your health care provider. First, a thorough history and physical examination will be done. Laboratory testing may also be done to check for TSH (thyroid stimulating hormone) and thyroid hormone levels, such as T3 and T4. Depending on your results, your health care provider may order diagnostic testing to view pictures of your thyroid.
Treatment of thyroid disorders is directed towards the cause of the disease. In hyperthyroidism, the three treatment options are antithyroid medications, radioactive iodine, and surgical removal of the thyroid gland. Medications called beta-blockers may be given to improve symptoms such as rapid heartbeat and trembling. Although they have no effect on the level of thyroid hormones, beta-blockers work by blocking the action of thyroid hormones on your body.
Hypothyroidism is most commonly treated with thyroid hormone replacement. Improvement of symptoms with hormone replacement usually takes around two weeks but can take longer. Medication treatment needs to be monitored by your health care provider, so make sure you schedule regular visits.
This information is for educational purposes. Please consult your physician for any medical issues. The Visiting Nurse Association (VNA) is committed to bringing trusted and quality home health, hospice and private care to Indian River County and Brevard patients. For more information about VNA services, call 772.494.6161 or visit www.vnatc.com.