It’s a common set of disorders that can cause an array of troubling symptoms, from significant weight loss or gain to hyperactivity or sluggishness to bulging eyes and excessive sweating. If you experience unexplained symptoms, you could have a thyroid disorder. According to the American Thyroid Association, 20 million Americans have a thyroid condition, and as many as 60% don’t know it.

These disorders can go undiagnosed because other conditions, such as anxiety or depression, can cause the same symptoms. Thyroid disorders occur predominantly in women, but most can be managed successfully, says Bryant Wilson, M.D., a general surgeon at Piedmont Atlanta Hospital.

How the thyroid works

The thyroid is a butterfly-shaped endocrine gland that sits at the base of the front of your neck. It regulates heart rate, metabolism and organ function. Thyroid disorders affect the gland’s ability to regulate the hormones it releases. Symptoms can vary greatly depending on whether you have too much or too little thyroid function. The most common disorders include hypothyroidism (too little function), hyperthyroidism (too much function), goiter (an enlargement of the gland that causes swelling in the neck), and thyroid nodules.

Causes of thyroid conditions

There are no precipitating causes for high or low thyroid function, which makes it difficult or impossible to prevent. Some conditions may be inherited, so if a thyroid disorder runs in your family, be vigilant about having your thyroid checked at your annual physical, Dr. Wilson says. “Most doctors are checking the thyroid gland as part of a routine physical to see if there are any nodules or changes,” he says.

“Most will obtain a thyroid function test as part of a yearly screening. This is probably something women who want to become pregnant should check. It’s normal for thyroid function to be high during pregnancy, but you want to make sure thyroid function is normal.”

Hypothyroidism

Hypothyroidism results from too little thyroid activity, which causes the body to function metabolically slowly. “Hashimoto’s disease is the most common cause of hypothyroidism. It is an autoimmune disease where the body attacks the thyroid as foreign tissue,” Dr. Wilson says. 

Symptoms include:

• Weight gain
• Droopy eyelids
• Slow speech
• Slow pulse
• Puffy or swollen face
• Coarse, dry and thickened skin
• Spare, coarse and dry hair
• Hoarse voice
• Dull facial expressions
• Constipation
• Muscle cramps
• Orange-colored soles and palms
• Hand tingling or pain (Carpal tunnel syndrome)
• Thinning eyebrows
• Confusion
• Increased menstrual flow in women

When left untreated, hypothyroidism can lead to low body temperature, anemia, heart failure and coma.

Hyperthyroidism

Hyperthyroidism is caused by too much thyroid activity. “The most common cause of hyperthyroidism is Graves’ disease, which predominantly affects women,” Dr. Wilson says. In addition to the below symptoms, those with Graves’ disease often experience bulging eyes, goiter and thickened skin on their shins.

Symptoms include:

• Weight loss
• High blood pressure
• Eye sensitivity to light
• Staring
• Confusion
• Thinning of the skin
• Fine, brittle hair
• Excessive sweating
• Fast heartbeat
• Difficulty sleeping
• Increased bowel movements
• Shaky hands
• Nervousness
• Irritability
• Weak muscles, particularly in the upper arms and thighs
• Shaky hands
• Irregular menstrual cycle

Goiter

Goiter is any type of enlargement of the thyroid gland. It can be caused by hypothyroidism, hyperthyroidism or, rarely, thyroid cancer. Graves’ disease-related goiter usually causes swelling in the entire thyroid gland. In other cases, goiter is caused by several smaller nodules on the gland. In any case, medical attention is required.

Thyroid nodules

Nodules or tumors can occur in the form of a single lump or multiple lumps on either side of the thyroid gland. While most nodules are not cancerous, a doctor can test the lumps to see if they are benign or malignant. Noncancerous nodules may secrete thyroid hormone, leading to an overactive thyroid. To treat this condition, surgery can be performed to remove the overactive nodule. “It’s important that if there’s a nodule, it’s addressed and the patient receives care,” he says.

Treatment and recovery

Keep in mind that many of the above-mentioned symptoms can be caused by other conditions, not necessarily thyroid disorders. However, if you are diagnosed with a thyroid condition, there are many treatment options. “With hypothyroidism, the thyroid is not likely to recover,” Dr. Wilson says. “Patients will need to take replacement hormones, usually in the form of one tablet a day, for the rest of their lives.”

Patients with hyperthyroidism have several treatment options. If the disease is mild, they may not need treatment. If it is significant, there are several methods, such as blocking the production of the hormone with medication or permanently killing off thyroid cells with radioactive iodine. In that instance, the patient would require lifelong replacement therapy. Nodules can be removed through surgery.

When to see your doctor

“If there’s suspicion of any of these disorders, go to your doctor and have function tests, or have any nodules assessed and evaluated,” Dr. Wilson says. “Early intervention makes treatment a great deal more successful. Left untreated, prolonged periods of high or low thyroid function can cause significant problems.”

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