DOVER –– The thyroid –– a tiny, butterfly-shaped endocrine gland located in the lower front of the neck produces hormones that influence the function of almost every cell, tissue and organ in our bodies and January is the month designated to learn more about the thyroid.
“I typically explain it as either a timing belt in a car or the conductor of an orchestra,” Dr. Anita Raghuwanshi, an endocrinologist at Beebe Healthcare in Lewes said.
According to the American Association of Clinical Endocrinologists, thyroid hormones are most notably responsible for controlling body temperature, stimulating heart contractions, maintaining proper brain function, managing energy expenditure (weight) and regulating the digestive tract but along with it’s positive functions come an opportunity for a lot to go wrong.
“If you have a condition like hyperthyroidism, your thyroid is telling your body to go too fast and since it controls so many functions, the results are basically the same as taking speed,” Dr. Raghuwanshi said.
Hyperthyroidism is usually caused by an auto-immune deficiency disorder called Graves’ disease.
“Graves’ disease is a condition where our immune system, by mistake, makes an antibody that activates the TSH (thyroid-stimulating hormone) receptor site on the thyroid cells, so the thyroid thinks the brain is telling it to make more thyroid hormone,” Dr. Raghuwanshi said.
Hyperthyroidism is one of the most common thyroid illnesses in addition to hypothyroidism — a condition where the thyroid does not produce enough hormones, making the body move more slowly than it should.
Dr. Raghuwanshi said the most common cause of low thyroid function is an autoimmune condition called Hashimoto’s, where our own immune system mistakes the thyroid for a foreign invader and starts attacking and destroying the thyroid.
Conditions like Hashimoto’s and Graves’ disease are much more common in women just like all auto-immune diseases. Dr. Raghuwanshi said women are about three times more likely than men to have an autoimmune disease but the explanation of the gender imbalance is a difficult one.
“We don’t have a perfect answer as to why women are affected so frequently,” she said.
The most popular explanations attribute the gender imbalance to hormones (estrogen versus testosterone levels).
The American Thyroid Association estimates that about 12 percent of the American population will develop a thyroid disease during their lifetime and about half of those individuals will go undiagnosed, many times because they are unaware of warning signs to look out for.
In cases of hyperthyroidism Dr. Raghuwanshi said symptoms can include heart palpitations, uncontrolled sweating (not explainable by menopause), new anxiety or insomnia (not caused by life stressors) and weight loss.
She explained symptoms of hypothyroidism are much more subtle and include constipation, dry skin, brittle hair, excess fatigue, doughy skin, and changes in patterns of hair growth. Since these symptoms are non-specific, they could be related to plenty of other conditions not involving the thyroid.
“You should have your primary care physician check a TSH and Free T4. If either of these are abnormal, they can refer you to an endocrinologist,” Dr. Raghuwanshi said. “Your primary care doctor is allowed to screen your thyroid function up to once every 6 months.”
The blood tests and simple and return very accurate results.
She cautions individuals from self-medicating with supplements like iodine if they suspect their thyroid is the cause of symptoms.
“The problem we see is that people start taking supplements on their own and their body becomes dependent on a supplement they never needed in the first place,” she said. “So you should be tested and if your symptoms are the product of a thyroid disorder, you should find a doctor you trust and work with them to figure out the best solution to your specific problem.”
In many instances, people self medicate with iodine because iodine is the fuel of the thyroid.
Iodine should be part of a balanced diet and is easily provided through iodized salt –– so when given an option of salt, iodized is usually the best way to go. Levels of iodine in sea salt are not regulated so there’s no guarantee your body is being provided with an adequate amount of iodine.
When there is not enough iodine reaching the thyroid, it will enlarge in an attempt to collect more iodine from the blood and the enlargement is called a goiter.
“Typically goiters are something you see in third-world countries, because they’re mostly caused by an iodine deficiency,” Dr. Raghuwanshi said.
Unfortunately there are still cases of goiters caused by iodine deficiencies in the U.S. but the majority of cases in the U.S. are related to the autoimmune disorders Hashimoto’s and Graves’ disease.
The American Thyroid Association reports that Hashimoto’s is the more common of the two diseases to cause goiters in the U.S. because as the thyroid becomes more damaged, it is less able to make adequate supplies of thyroid hormone. The pituitary gland senses the problem and secretes more TSH to stimulate the thyroid and the stimulation causes the thyroid to grow.
On the other hand, Graves’ disease produces too much thyroid hormone and the pituitary gland tries to stop secretion of TSH. In spite of the effort to stop production, the thyroid gland continues to grow and make thyroid hormone.
If you experience any symptoms or hyper or hypothyroidism or develop a goiter, contact your primary care physician to be screened for thyroid hormone levels.
More information about the thyroid can be found online at thyroidawareness.com or thyroid.org.