The little gland with a big job: exploring thyroid disorders

A malfunctioning thyroid can cause a plethora of frustrating issues for adults and even some adolescents.

Nearly 30 million Americans have been diagnosed with thyroid disorders, and nearly 60% of people experiencing thyroid issues remain undiagnosed, according to the American Association of Clinical Endocrinology, or AACE.

Women, who have a one-in-eight chance of developing a thyroid disorder through their lives, are five to eight times more likely than men to have thyroid disorders.

Hashimoto’s thyroiditis, Grave’s disease and goiters are a few things that can occur when a person’s thyroid is out of whack.

“Autoimmune disorders have been on the rise, and we don’t know why,” said UCHealth endocrinologist Dr. Richard Millstein.

Dr. Richard Millstein is an endocrinologist at UCHealth. (Photo courtesy UCHealth)

The thyroid is a butterfly-shaped gland located in the base of the neck. Though small in size, the thyroid plays a huge part in how the body’s organs function, including the heart, brain, liver and skin.

Thyroid glands make two different types of hormones, triiodothyronine, or T3, and thyroxine, known as T4, explained Dr. Nirmala Kumar, an endocrinologist with Banner Health in Greeley. These hormones travel throughout the body to regulate things such as blood pressure, temperature and metabolism.

Levels of T3 and T4 hormones are regulated in the brain by the pituitary gland. The pituitary gland creates a thyroid-stimulating hormone, TSH, that tells the thyroid when to make hormone and how much to make.

If the thyroid and pituitary gland are not functioning or communicating properly, it can lead to either hypothyroidism, when it produces too little hormone, or hyperthyroidism, when it produces too much hormone.

“The normal level that we have for UCHealth is 0.45 to 4.6,” Millstein said. “I’ve seen 2,000 before, which is obscenely high.”

Some symptoms associated with thyroid disorders are:

  • Unexplained weight change
  • Depression
  • Anxiety
  • Inability to concentrate or remember things
  • Trouble sleeping
  • Irregular menstrual cycles
  • Weakness
  • Joint or muscle pain
  • Constantly feeling cold
  • Brittle nails, hair or both

Many of these symptoms can be seen in a variety of conditions or diseases, so just because you are experiencing some of these, it doesn’t mean you have a thyroid disorder, Millstein said. People have to take a blood test to determine if the issues are indeed caused by their thyroid or by something else.

According to Kumar, depending on the severity, thyroid disorders can be treated with medication, which come in a natural form made from desiccated pig thyroids and synthetic forms. Surgery is sometimes an option as well.

“The first medication found to work came from Armour Thyroid, from the Armour hot dog company,” Milstein said, chuckling. “You can’t put thyroids in hot dogs so you have to figure out something else to do with them.”

Thyroid disorders are one of the few conditions that can’t be controlled or reversed with diet.

“There’s no data showing that a special diet will fix a thyroid issue,” Millstein explained. “You can recheck antibodies all you want after diets, and even if the antibody levels were to go down, you’re still on thyroid medicine. It doesn’t change anything which is the hard part.”

While rare, thyroid cancers can cause a person to have difficulty swallowing, neck or throat pain, swollen lymph nodes in the neck and changes to a person’s voice, according to the Mayo Clinic.

Treatments for thyroid cancer can include radiation, surgical removal of the gland and medications.

“No matter how we try to calculate, we never get the exact correct amount of radiation so patients end up being underactive and have to take thyroid hormone for the rest of their lives,” Kumar said. “The same with surgery because you are removing the whole thyroid.”

AACE offers a video on their website on how to do a self-check of your thyroid. To view the video, go to http://bit.ly/2NgGfqL.

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