Medically reviewed on January 7, 2022 by Jordan Stachel, M.S., RDN, CPT. Last updated January 4, 2023. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
The American Thyroid Association estimates that about 12 percent of Americans will develop a thyroid condition of some kind in their lifetime. About 20 million Americans have some form of thyroid disease .
The thyroid is an incredibly important gland, and any issues or malfunctions in the thyroid can contribute to severe health issues. What’s concerning is that thyroid problems can be hard to pinpoint. Estimates suggest that about 60 percent of Americans with thyroid disease don’t even know that they have it . Symptoms may be easy to mistake for other health problems, or people may ignore thyroid symptoms altogether. However, discerning the early signs of thyroid disease means getting help and treatment sooner. Learn more about thyroid problems and some potential early signs of thyroid disease below (and consider learning more about at-home thyroid testing).
The thyroid is a gland that is part of the body’s endocrine system. Relatively small in size, the thyroid gland is a butterfly-shaped gland that wraps around your trachea at the front of your neck . The thyroid functions to produce hormones that are involved with regulating your metabolism. Your metabolism is the process through which digestible nutrients get turned into usable energy. With the right balance of these hormones, your metabolism can work at a proper rate .
Aside from regulating your metabolism, your thyroid hormones are involved in a variety of bodily functions, including:
The thyroid produces two hormones: T3 and T4. T3 is known as triiodothyronine, while T4 is known as thyroxine. T3 is the more active of the two hormones, but only about 20 percent of the thyroid’s production comprises T3. The other 80 percent comprises T4 . However, enzymes in the liver, kidneys, and other tissues convert T4 into the more bioactive T3 .
Maintaining a balance of the thyroid hormones and knowing how to understand thyroid levels is the key to upholding your overall health and the health of your thyroid gland. Thyroid hormone production is regulated by the pituitary gland. This gland sits at the bottom of your brain and produces a hormone called thyroid-stimulating hormone (TSH). If the levels of thyroid hormones decrease too much, the pituitary gland produces TSH to stimulate the thyroid gland to produce more hormones.
The pituitary gland is regulated by the hypothalamus, another gland that sits just above the pituitary. The hypothalamus gets signals from the brain to release a hormone called thyrotropin-releasing hormone (TRH). This hormone stimulates the pituitary gland to release TSH, which then signals the thyroid to release its own hormones .
This is a complex series of processes, but it’s all well-regulated in a healthy human. The brain is constantly adapting throughout the day based on your body’s needs, thyroid levels, and any metabolic changes.
The two main types of thyroid disease are hypothyroidism and hyperthyroidism. An underactive thyroid can result in your body not making enough thyroid hormones. This is known as hypothyroidism . Alternatively, an overactive thyroid, known as hyperthyroidism, can cause an overproduction of these hormones .
These two conditions can share some broad similarities, but many potential early signs of thyroid disease can be hard to miss. Here are some of the most common signs of thyroid dysfunction.
Your metabolism is how your body utilizes food and converts it into usable energy. That process is naturally linked to your weight. Without enough thyroid hormone, your metabolism may slow down, which can result in unintended weight gain. Even with changes to your diet and exercise regimen, weight gain can be hard to shed if you have a hormone imbalance .
Alternately, with hyperthyroidism, you may lose weight unintentionally, even without changing your diet or physical activity .
Along with its close link to your metabolism, your thyroid can also affect your digestion, leading to potential gastrointestinal issues. You may experience frequent bowel movements or constipation depending on your thyroid hormone levels.
Thyroid problems can potentially contribute to changes in mood, most often manifesting as depression and/or anxiety. Usually, the more severe your thyroid issues, the more severe the mood disorders .
With hypothyroidism, you may be more prone to symptoms of depression . Those with hyperthyroidism may experience nervousness, irritability, and anxiety .
Your metabolism plays an integral role in your temperature regulation. For example, when you’re cold, you naturally burn more calories to keep your body warm .
Fluctuations in your metabolism can then obstruct your body’s natural temperature regulation. When your thyroid is underactive, you might get cold easily. Winters may feel unbearable, or you may have to turn up the heat in your home even when it’s a relatively warm day . Alternately, if you have an overactive thyroid, you may have difficulty with hot weather. You may sweat even in perfectly mild climates, or you may turn on the air conditioner even on colder days .
Thyroid problems can contribute to ongoing sleep disturbances. Hypothyroidism may contribute to sleep issues through obstructive sleep apnea. Sleep apnea is a disorder in which you periodically stop breathing in your sleep. Obstructive sleep apnea is a form of this disorder characterized by physical obstructions that prevent you from breathing freely in your sleep. Hypothyroidism can cause obstructive sleep apnea through multiple factors, like enlarging the tongue, disrupting the muscles that control your airways, or causing damage to the nerves and muscles involved with breathing .
Hyperthyroidism may cause sleep problems by contributing to night sweats. Remember, thyroid issues can disturb your temperature regulation. At night, that may translate to hot flashes and night sweats that can keep you up or otherwise prevent you from getting a good night’s sleep .
If you have thyroid problems, you may notice swelling or nodules on your neck, where your thyroid is located. Swelling of the thyroid nodules is typically a sign of thyroiditis–or an inflamed thyroid. Nodules or lumps usually are not serious, but a very small portion may be cancerous. If you notice any growth or deformation in your neck, you should get it checked out immediately, even if it isn’t thyroid-related.
Without the help of blood tests, thyroid issues are often misdiagnosed due to their ambiguous, broad range of symptoms . For example, Hashimoto’s disease, an autoimmune disease that affects the thyroid gland, often resembles hyperthyroidism in its early stages due to the similarity of symptoms such as difficulty with sleep, heat sensitivity, and elevated heart rate. If Hashimoto’s disease is left untreated, symptoms will eventually shift to resemble that of hypothyroidism, which can include fatigue, digestive issues, and dry skin. This is why it’s important to test for thyroid dysfunction as soon as symptoms develop to ensure accurate diagnosis and treatment.
However, these symptoms aren’t always indicative of thyroid dysfunction. Symptoms such as constipation, chronic fatigue, brain fog, or anxiety can all point to poor gut health. Taking steps to improve digestive health such as the following could help address some of these symptoms:
Studies have shown that the gut microbiome plays a role in the absorption of key minerals that support thyroid activity, indicating a clear link between gut health and thyroid function .
Once your healthcare provider has identified your thyroid problem, you can typically receive treatment to manage your symptoms and regain healthy hormone levels. Hypothyroidism is usually treated with synthetic thyroid hormones, which restores your thyroid hormone levels and reverses signs and symptoms of low thyroid hormones. Hyperthyroidism can be treated with a variety of treatment options designed to reduce thyroid hormones or slow down hormone production.
It’s impossible to diagnose yourself based on just the above symptoms alone. The only real way to know if you have a thyroid problem is to take a blood test and receive a diagnosis from your healthcare provider. Everlywell offers an at-home thyroid test that measures your thyroid hormone levels. If the results come back with any abnormalities, you can take them to your healthcare provider and determine any necessary steps for treatment and better health.
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