Managing Thyroid Health: A Guide to Thyroid Awareness and Support

Almost everyone has heard of the thyroid gland, but most people don’t know much about it. If your thyroid is functioning properly, you don’t have much reason to even think about it. Your thyroid is fine now, but that might not always be the case. More than 12% of Americans will develop a thyroid condition in their lifetime, and women are five to eight times more likely than men to develop thyroid problems. An estimated 20 million people in the U.S. currently suffer from some form of thyroid disease, and up to 60% of them have no idea. Take a few minutes to increase your thyroid awareness today — it could save your health in the future.

Understanding the Thyroid Gland

Your thyroid is a small gland that is shaped like a butterfly and located in the front of your neck, across your windpipe. It is an important part of your body’s endocrine system. It is responsible for many important body functions, which it achieves by both producing and releasing certain hormones. These hormones regulate vital functions like your metabolism, energy levels and emotional equilibrium. The main job of the thyroid is to control the speed of your metabolism, known as your metabolic rate; this process is responsible for turning the food you eat into energy. 

Thyroid Hormones

Your thyroid produces and secretes four different hormones:

• Thyroxine (T4): This is the main thyroid hormone and is produced in the greatest quantities of the four. Though it only has a slight effect on your metabolism, a process called deiodination converts it into another hormone called T3. 
• Triiodothyronine (T3): T3 affects most of your bodily processes, including metabolism, body temperature, heart rate and growth and development. It is produced in smaller amounts than T4.
• Reverse triiodothyronine (RT3): RT3 is a hormone that reverses the effects of T3. The thyroid produces very small amounts of this hormone. 
• Calcitonin: This thyroid hormone plays an important part in regulating how much calcium is in your blood.

Your thyroid needs iodine to make these hormones. Iodine is an element found in food and water, most commonly in iodized table salt (which you likely have in your home and consume often). When you consume iodine, your thyroid is able to use it to make and release hormones. Having too much or too little iodine in your body can affect your thyroid’s ability to produce hormones.

As you now know, one of the biggest bodily functions that your thyroid affects is your metabolism (how your body uses energy). The thyroid also plays a role in regulating many more bodily functions, which are listed below:

• Breathing
• Digestion
• Heart rate
• Brain development
• Body temperature
• Skin and bone maintenance
• Mental activity
• Fertility

Common Thyroid Disorders

Hypothyroidism: Also known as an underactive thyroid, hypothyroidism occurs when your thyroid doesn’t make enough of certain hormones. It may not cause symptoms at first, but over time can lead to serious health conditions including heart problems and high cholesterol levels. 

Hyperthyroidism: When your thyroid makes too much of certain hormones, it’s known as an overactive thyroid or hyperthyroidism. This condition speeds up the body’s metabolism and commonly causes a range of symptoms, including weight loss, shaking hands and a fast or irregular heartbeat.

Goiter: When the thyroid becomes enlarged, it is known as a goiter. About 5% of Americans have a goiter, and it is usually not dangerous unless thyroid cancer is causing it. If a goiter gets big enough, the neck becomes visibly swollen. Symptoms of goiters include coughing, voice changes and difficult breathing or swallowing.

Thyroid Cancer: According to the Centers for Disease Control (CDC), each year 33,000 women and 12,000 men are diagnosed with thyroid cancer, and about 1,000 women and 900 men die from it.

Hashimoto’s Disease: Hashimoto’s is an autoimmune disorder that results in the death of the cells in your thyroid that produce hormones. This usually leads to hypothyroidism. Hashimoto’s is most common in middle-aged women, but it can develop in anyone. Treatment typically consists of thyroid hormone replacement.

Graves’ Disease: Graves’ disease is an autoimmune disorder that causes your thyroid to produce too much of certain hormones, resulting in hyperthyroidism. Graves’ can also cause eye inflammation, resulting in swelling or bulging of the eyes. Treatment usually involves beta-blockers and/or antithyroid medications.

Types of Thyroid Cancer

• Papillary thyroid cancer: This is the most common type of thyroid cancer and is most common in people aged 30-50. Most cases of this type respond well to treatment. 
• Follicular thyroid cancer: This rare type most often occurs in people over age 50 and usually doesn't spread to the lymph nodes. Aggressive forms may spread to other parts of the body, most commonly the lungs and bones. 
• Medullary thyroid cancer: Another rare type, this cancer begins in thyroid cells called C cells, which produce calcitonin. This type of cancer is sometimes caused by the RET gene, which is inherited by children from their parents.
• Anaplastic thyroid cancer: This rare type is often difficult to treat and tends to grow quickly. Usually occurring in people over 60, it can cause severe symptoms like trouble breathing due to neck swelling that quickly gets worse. 

Thyroid and Type 2 Diabetes

Low levels of thyroid hormone may put you at higher risk for type 2 diabetes. New research presented at the Endocrine Society’s annual meeting suggests that having too little thyroid hormone, whether your levels are in the hypothyroid range or are just on the low-normal side, raises your risk for developing type 2 diabetes, especially if you have pre-diabetes.

Type 2 diabetes is an epidemic in the United States. In fact, a study recently published in the Journal of the American Medical Association estimated that 50 percent of American adults have type 2 diabetes or prediabetes, a condition in which blood sugar levels are higher than normal but not high enough to be considered diabetes.

“Thyroid hormones are a key component of maintaining a healthy metabolism,” explains Dr. Andrea Klemes, endocrinologist and chief medical officer, MDVIP. “This means that having less thyroid hormones can often lead to weight gain and a lower sensitivity to insulin, raising the risk for type 2 diabetes.”

Risk Factors and Diagnosis

There are many known risk factors for developing thyroid diseases or cancers. Some of the most common include:

• Preexisting autoimmune condition: There are several autoimmune diseases that can cause thyroid issues and/or increase your risk of developing thyroid disease, including Type 1 Diabetes, Celiac and Graves Disease.
• Gender: Women are at a significantly higher risk for all types of thyroid problems. 
• Age: Those over age 60 are at the highest risk for thyroid problems.
• Genetics: You are more likely to develop thyroid disease if you have a family history of thyroid problems. 
• Pregnancy: Estrogen is responsible for regulating globulin, the protein that binds to the thyroid hormone in the bloodstream. Because pregnancy affects estrogen production, it increases the risk of developing thyroid problems. These symptoms of hypothyroidism and menopause can magnify one another.
• Menopause: Like pregnancy, menopause changes the balance of estrogen in the body. This increases the risk of thyroid problems, particularly hypothyroidism; the risk increases for menopausal women on supplemental estrogen treatment.
• Smoking: Many studies have linked smoking to changes in thyroid function. For example, smoking may decrease TSH. Smoking may also influence Grave’s hyperthyroidism, among other issues.

Diagnosis of Thyroid Disease

An important component of thyroid disease awareness is knowing your risk factors. If you are at risk for developing thyroid disease — meaning you have one or more of the known risk factors listed above — it is important to get regular thyroid screenings from your doctor.

Thyroid diseases and thyroid cancers can be diagnosed with blood tests. The most common thyroid blood tests are:

• TSH Test: When thyroid disease is suspected, the first test usually done is the thyroid-stimulating hormone (TSH) test. This test is also commonly included as part of routine blood work in an annual physical. TSH above 4.0 mU/L usually indicates hypothyroidism, while TSH below .4 mU/L is indicative of hyperthyroidism.
• T4 Test: High levels of T4 can mean hyperthyroidism. 
• T3 Test: This test is often given when your doctor suspects you have hyperthyroidism despite a normal T4 test. Some people with hyperthyroidism have normal levels of T4 and high levels of T3.
• Thyroid antibody test: When you have an autoimmune disease like Hashimoto’s or Graves’, your body produces thyroid antibodies. If you have symptoms of one of these thyroid-related autoimmune diseases, this test can confirm the diagnosis. 

How to Support Thyroid Health

Adopting healthy lifestyle practices—like exercising and eating healthier— can lower your risk of thyroid issues. Other modifications can promote a healthy thyroid. Here are some changes you can make:
What can you do to maintain your thyroid hormone levels, as well as help control hypothyroidism? Here are some tips.

• Don't smoke. Smoking raises your risk of hypothyroidism. And if you are diagnosed with hypothyroidism, smoking raises your risk of developing one of the many complications associated with it like depression, cardiovascular disease and peripheral nerve damage. If you smoke and are ready to quit, work with your doctor to develop a personalized cessation plan. 
• Ask for a thyroid collar when getting dental, head, neck or shoulder x-rays.
• Choose natural or organic foods as processing strips many foods of their nutrients.
• Discuss taking a multivitamin-mineral supplement with your doctor if you are concerned that you’re not getting enough thyroid-supporting nutrients like iodine, selenium, zinc, iron and copper.
• Avoid skipping meals and eat breakfast within one hour of waking to avoid stressing the thyroid.
• Steam or cook cruciferous vegetables like broccoli and cabbage whenever possible. Raw cruciferous vegetables have known to suppress thyroid hormones. However, heating these vegetables alter their molecular structure, making it safer for the thyroid.
• If you are sensitive to gluten products, discuss a gluten-free diet with your doctor. Gluten sensitivities can contribute to an array of autoimmune disorders including hypothyroidism. However, because gluten has nutritional benefits, it’s important to discuss important dietary decisions such as this with your doctor.   
• Lower your stress levels. Your body’s response to stress involves producing the hormone cortisol which can impair thyroid function and cause a resistance to host of hormones, interfering with a wide array of bodily functions.  
• Exercise regularly. Physical activity can stimulate the thyroid to produce hormones and increase your body’s tissue’s sensitivity to thyroid hormones. Be sure to talk to you doctor before beginning an exercise program.

Working with your MDVIP-affiliated physician and staying current with your annual wellness program may help lower your risk of developing hypothyroidism and/or type 2 diabetes. If you have been diagnosed with either condition, your doctor can help you manage the condition(s), treat complications and coordinate your care with specialists. Click here to learn how MDVIP-affiliated primary care doctors can help you manage chronic conditions.

Frequently Asked Questions About Thyroid Disease

Q: Can thyroid disorders be treated?
A: Yes, most thyroid disorders are treatable. Treatment options include thyroid hormone replacement, medications to control hormone production, radioactive iodine and surgery in some cases.

Q: Is it necessary to get regular thyroid check-ups?
A: Regular check-ups are especially important for those at risk or showing symptoms. Early detection can make management of thyroid disorders more effective.

Q: Why are women more likely to develop thyroid problems?
A: Women are more likely than men to have autoimmune diseases, which are a frequent cause of thyroid disease. Additionally, estrogen increases the body’s amount of thyroid-binding globulin, which can increase how much thyroid hormone you need during treatment for thyroid disease.