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Madison, Wis. — Perhaps the reason a quick Google search reveals these alarming headlines is the symptoms for hyperthyroidism and hypothyroidism are highly varied and cannot always be strictly quantified.
"The signs of thyroid abnormality are vague and encompass a lot of different organs," says Dr. Christa Pittner-Smith, a UW Health family medicine physician who practices at the Cottage Grove Clinic.
About The Thyroid
The thyroid is the gland that produces the hormones - triiodothyronine (T3) and thyroxine (T4) - that circulate in the bloodstream to control your metabolism and regulate your heart rate, blood pressure, body temperature and how the body converts food to energy.
It has an impact on every cell in your body, so when thyroid problems develop, they manifest in a number of different ways.
Hypothyroidism occurs when the thyroid produces too little T3 and T4. It is more common in older females, affects 4.6 percent of people in the United States and can cause a wide range of symptoms, including "fatigue or feeling slow," says Dr. Pittner-Smith. "Sometimes people feel down or depressed. Hypothyroidism can cause weakness and muscle cramps and make people overly sensitive to cold temperatures. It can also cause constipation and decreased appetite with weight gain."
Too many T3 and T4 hormones results in hyperthyroidism. It affects fewer people - a bit more than 1 percent of the U.S. population - but is 10 times more likely in females than males. Its symptoms are more or less the opposite of hypothyroidism.
"Hyperthyroidism can make people feel anxious and cause the heart to race," says Dr. Pittner-Smith. "It can make people feel warm and have a bigger appetite with weight loss. In severe cases, hyperthyroidism can cause tremor, shakiness, and muscle weakness, and even eye pain or swelling."
It's an extensive list of symptoms, and not necessarily confined to the thyroid. Fatigue and constipation can be caused by a lot of things. The same goes for anxiety and a bigger-than-normal appetite. So how is a person to know if their shakiness or sluggishness is thyroid-related?
Sorting Through the Symptoms
How Do I Find a Family Doctor?
The first step is to talk to your primary care doctor, says Dr. Pittner-Smith. Primary care doctors can thoroughly explore their patients' symptoms to determine if they are attributable to the thyroid, or if the problem lies elsewhere.
Dr. Pittner-Smith finds that a detailed history and frank conversation can go a way toward accurate identification of the problem.
"We talk through all of those conditions and about the patient as a whole, to see what might be causing the issues," Dr. Pittner-Smith says. "If a thyroid issue is high on that list, we'll test right away. If it's lower on the list, we'll look at other tests first and may return to the thyroid later on, if we're not getting to the root of the problem."
If those conversations suggest hyperthyroidism or hypothyroidism, Dr. Pittner-Smith may order a test to provide ultimate confirmation. Blood tests that measure the amount of thyroid-stimulating hormone (TSH) are the preferred method of detecting hypothyroidism and hyperthyroidism.
In hyperthyroidism a nuclear medicine scan, during which patients take a small, oral dose of radioactive iodine that collects in the thyroid, may be ordered to further explore the cause.
The news is good for patients who are determined to have either of the aforementioned thyroid conditions. Success rates of treatment are high and treatment may be as simple as taking a medication once a day.
"Medications can be very effective for the treatment of an underactive thyroid. It can take a few months to see the impact of the medication, but most patients respond very well to treatment." says Dr. Pittner-Smith. "if patients need treatment beyond medications, we are lucky, at UW Health, to have world-class specialists in both nuclear medicine and endocrine surgery who are experts in treating thyroid disease."