Despite its size, your thyroid-the small butterfly-shaped gland located at the base of your throat-may be the most powerful part of your internal anatomy. The hormones it pumps out regulate everything from your appetite and energy levels to your body's internal thermostat. That's all well and good when it's working properly. But because your thyroid is so versatile, if it acts up, you could feel the effects in unpredictable ways.
"Especially in terms of hypothyroidism, or an underactive thyroid, it's hard to make a diagnosis based on symptoms alone," says endocronologist Dr Antonio Bianco. "The best way for making a diagnosis is with a blood test," Dr Bianco adds. (More on that in a minute.)
While an overactive thyroid (hyperthyroidism) is often simpler to pin down, Dr Bianco says most symptoms associated with a thyroid going haywire are also characteristic of other common health conditions-including depression, menopause, and chronic fatigue syndrome. "We say symptoms are 'suggestive' of over- or underactive thyroid, but laboratory confirmation is always needed," he says.
Because symptoms vary, lots of people are living with thyroid issues without realising it. Also, women are five to eight times more likely to have thyroid problems than men are.
Symptoms of Thyroid Problems
Although no individual health issue is a sure sign of a thyroid condition, there are symptoms more commonly linked to an over- or underactive thyroid. Here are those symptoms-and what to do if you experience them.
Underactive Thyroid (Hypothyroidism)
According to Dr Bianco, symptoms include:
- Feeling cold all or much of the time
- Chronic fatigue or muscle pain
- Dry skin
- Hair loss
- Abnormally heavy periods
- Weight gain
- Constipation
If you have symptoms of an underactive thyroid...
Visit a doctor and get a blood test, Dr Bianco says. "The test measures serum thyroid-stimulating hormone, or TSH," he explains.
If your blood test shows a TSH level between 0.4 and 4.5 milliunits per liter (mU/L), that's normal, Bianco says. If yours is at 10 mU/L or above, you have hypothyroidism. But between 4.5 and 10 mU/L, you fall into a grey zone — what Bianco calls subclinical hypothyroidism. "There are no clear risk factors or health conditions associated with a TSH in this range, so we treat this on a case-by-case basis," he says.
Based on how you're feeling and your blood test, your doctor will help you decide if hormone therapy is appropriate.
Overactive Thyroid (Hyperthyroidism)
According to Dr Bianco, symptoms include:
- Eyes bulging
- Feeling hot all the time
- Heart racing, especially during exercise
- Anxiety or nervousness
- Vision problems
- Weight loss
- Increased sweating and/or clammy hands
- Increased bowel movements
- Abnormally light periods
If you have symptoms of an overactive thyroid...
Dr Bianco says an overactive thyroid is easier to diagnose based on symptoms alone. Still, your doctor will want to confirm the diagnosis with that serum TSH test.
"If your TSH is at zero, that's clinical hyperthyroidism and you're probably experiencing all or most of those symptoms," Bianco says. If your TSH is low but above zero, your doctor may still choose to treat you-even if you aren't experiencing any symptoms at all.
Here's why: "An excess of thyroid hormone has been linked to atrial fibrillation, so it affects the heart and could cause blood clots or stroke," Bianco says. Research has also linked an overactive thyroid to higher risk of osteoporosis.
So unlike subclinical hypothyroidism, subclinical hyperthyroidism may require treatment even if you feel fine, he adds.
How do you know if you have a thyroid problem?
Thyroid problems are shifty and unpredictable. Because the associated symptoms are inconsistent from person to person, diagnosis can be difficult. If you're experiencing a couple of the symptoms mentioned above, and especially if they've cropped up suddenly, see your doctor.
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