What is the Thyroid?
The thyroid is a small gland in the front of the neck below the Adam’s apple. It’s shaped like a butterfly and is part of the endocrine system. It works with the help of the thyroid stimulating hormone (TSH), which is actually produced by the pituitary gland, another gland in the endocrine system found at the base of the brain.
“Thyroid stimulating hormone is produced by the pituitary gland and is responsible for controlling the amount of thyroid hormones, T3 and T4, which is released by the thyroid,” Leclere says.
The thyroid gland uses iodine from ingested food to produce thyroid hormone and operate correctly. In developing countries, iodine deficiency has been recognized as a main cause of thyroid diseases. However, Leclere says that’s rarely a problem in North America, as our salt is fortified with iodine.
Hypothyroidism vs. Hyperthyroidism
Hypothyroidism occurs when there is a low level of thyroid hormone, and hyperthyroidism is when there is too much thyroid hormone. Both diseases are often caused by autoimmune disorders. Providers look for these symptoms to determine if you have a thyroid problem.
- Weight loss
- Irregular heart rate
- Sweating/heat intolerance
- High blood pressure
- Mental slowness
- Dry skin
- Hair loss
- Menstrual irregularities
- Cold intolerance
- Weight gain
“Hypothyroidism, the most common thyroid condition, affects about four in 1,000 people in the United States,” Dr. Baeth says. “It’s important to note while hypothyroidism is fairly common, quite often various symptoms are blamed on the thyroid, and patients are often shocked when their thyroid test comes back normal. A much more common cause of fatigue is lack of exercise, of weight gain, excess food, and of cold intolerance, lack of clothing.”
Treatment & Testing
The U.S. Preventive Services Task Force has determined there isn’t enough evidence to recommend screening the general population for thyroid disease, unless the patient has symptoms or is at high risk for the condition.
If a patient does require screening, it’s done through a simple blood test that measures thyroid stimulating hormone. A normal TSH level is roughly 0.4 – 4.0 uIU/mL, depending on the specific testing method used.
“First-line hypothyroidism treatment is a daily medication of synthetic thyroid hormone called Levothyroxine. Some people request to be prescribed Armour Thyroid, which is essentially dried and powdered pig thyroid, instead of the synthetic hormone. I discourage this, as studies suggest this compounded piece of pork is not a reliable replacement of human thyroid hormone,” Dr. Baeth says.
He adds it’s important to treat hypothyroidism because in rare cases, it can lead to irreversible damage to the heart and brain.
When it comes to hyperthyroidism treatment, there are several treatment options and your provider may even suggest a combination of treatments.
“The three most common treatments are: antithyroid medications (Thionamides), radioiodine or surgery. Your primary care provider will discuss with you the different options to best fit your condition,” Leclere says.
Unfortunately, there are no evidence-based guidelines for prevention of thyroid disease in the United States.