Understanding The Thyroid and Common Thyroid Symptoms
The thyroid gland is an essential hormone-producing organ, yet it is rarely discussed. You would have heard a lot about the brain, the heart, the lungs, and the kidneys, but only sometimes about the thyroid gland despite its vital and vast function in the body.
The thyroid gland is certainly mightier than its size of about 40 grams. It has a wide range of functions that include controlling how slow or fast your body metabolises or consumes energy, regulating body heat and temperature, regulating your heart rate, affecting brain growth and development in children, and affecting almost all organs in the body.
The thyroid gland is a butterfly-shaped gland consisting of the right and left thyroid lobes connected by an isthmus in the front of your neck, just below your larynx (the voice box that produces sound) or your Adam’s apple. Each thyroid lobe is the size of our thumb pad, weighing 15 – 20 grams. This gland produces three hormones: Triiodothyronine (T3), Thyroxine (T4), and Calcitonin. T3 and T4 correspond to the number of iodine molecules in the hormone; these play a crucial role in regulating various bodily functions, making the thyroid gland a key player in maintaining your overall health.
Thyroid hormone disorders are broadly categorised into two: (a) underproduction, insufficient, or too little thyroid hormones, which is known as hypothyroidism or underactive thyroid, and (b) overproduction or excessive thyroid hormones, which is known as hyperthyroidism or overactive thyroid gland.
Hypothyroidism and hyperthyroidism are on opposite spectrums. When these conditions occur, the functions they regulate within the body are either attenuated or exaggerated, resulting in thyroid signs and symptoms that you shouldn’t ignore, such as rapid or slow heartbeat, weight gain or loss, constipation or frequent bowel movements, and cold or heat intolerance.
What is Hypothyroidism?
Thyroid hormones must be within a certain level or range within the body. When the level of thyroid hormones is insufficient or excessive, this upsets the delicate balance of the body’s internal environment. When your thyroid gland does not produce enough hormones, it is known as hypothyroidism or underactive thyroid.
The most common cause of hypothyroidism is Hashimoto’s disease or Primary Autoimmune Hypothyroidism. This is an autoimmune condition when the body’s immune system, which usually protects us from infections and illnesses, mistakenly attacks its healthy thyroid cells and tissues.
Common symptoms that arise as a result of hypothyroidism include fatigue, weight gain, cold intolerance, dry skin and brittle hair, brain fog, depression, constipation, and slow heartbeat. What do these symptoms mean? Why do these symptoms arise? Read on as we examine these symptoms.
Fatigue
It is not uncommon to be fatigued or tired following stressful events, and most people are familiar with this experience. However, this kind of fatigue often goes away with adequate rest and sleep. This is, however, not the case for the fatigue caused by hypothyroidism, as the fatigue continues even with adequate rest and sleep. As a result of low thyroid hormones, your body’s metabolism is slowed, leading to less energy and causing fatigue or lethargy.
Weight Gain
The T3 and T4 hormones control the Basal Metabolic Rate (BMR), the amount of energy your body uses at rest. When there aren’t enough thyroid hormones, your body’s energy use or metabolism is slow, leading to weight gain.
Cold Intolerance
Another important function of thyroid hormones is heat regulation and temperature control. Reduced energy use results in reduced heat generation, which can cause cold intolerance.
Dry Skin and Hair
Your skin sheds off cells daily, and the thyroid hormones regulate this skin turnover. When there are insufficient thyroid hormones, this process is slowed, leading to dry skin. Similarly, the growth of hair follicles is controlled by thyroid hormones, and when there is too little, this process is slowed, leading to dry and brittle hair.
Depression
Thyroid hormones affect neurotransmitters (chemical messengers in your brain), especially serotonin and dopamine, which control mood. High levels of serotonin and dopamine lead to positive mood, while low levels cause feelings of hopelessness and low mood. Hypothyroidism leads to low levels of these neurotransmitters, resulting in depression.
Constipation
Thyroid hormones also affect the digestive muscles. Insufficient hormones lead to slower motility of the gastrointestinal tract, which can cause constipation.
Brain Fog
Insufficient T3 and T4 levels can impair memory and learning, leading to brain fog.
What is Hyperthyroidism?
An overactive thyroid, known as hyperthyroidism, occurs when the thyroid gland produces excessive T3 and T4 hormones. When this happens, the functions of the thyroid hormones in the body are exaggerated, resulting in different symptoms and signs.
Graves’ Disease is an autoimmune disorder (in which the immune system attacks the cells, tissues, and organs of the body) and is the most common cause of hyperthyroidism. Nervousness, rapid heartbeat, weight loss, heat intolerance, frequent bowel movements, tremors, fatigue, and insomnia are common symptoms of hyperthyroidism that you should be aware of and not ignore.
Nervousness
Thyroid hormones also regulate the nervous system. Excess T3 and T4 increase nervous system excitability, leading to nervousness.
Weight Loss
Hyperthyroidism increases the rate of energy consumption, leading to unintentional, rapid weight loss. This also leads to an increased appetite, but weight loss prevails despite the increased appetite.
Heat Intolerance
More energy expenditure results in more heat production; thus, a lack of tolerance to heat arises.
Tremors
Tremors are involuntary shaking of arms, legs, and other body parts. They occur when the nervous system is hyperactive due to increased T3 and T4 levels.
Rapid Heartbeat
The thyroid gland affects how fast or slow your heart beats. Excessive thyroid hormones increase heart rate, leading to rapid heartbeat.
Frequent Bowel Movements
Thyroid hormones regulate the motility and contraction of the bowel muscles. Excess thyroid hormones cause increased bowel muscle movement, leading to frequent bowel movements.
Fatigue and Insomnia
Your body consumes energy very quickly, which breaks down muscles and causes fatigue. An increased energy level leads to anxiety, increased wakefulness, and insomnia.
Severe Complications of Thyroid Disorders
The complications of hypothyroidism include:
- Myxedema Crisis: Myxedema is advanced hypothyroidism with skin changes. It occurs when the body can no longer cope with the long-term effects of hypothyroidism. Low blood pressure, decreased respiration, and low temperature are signs and symptoms of this life-threatening complication.
- Goitre: Thyroid gland enlargement can compress nearby structures, such as the voice box or larynx, causing hoarseness.
Complications of hyperthyroidism include:
- Thyroid storm: This is a life-threatening complication that happens when a trigger suddenly worsens hyperthyroidism symptoms. A medical emergency it can be triggered by an infection or pregnancy.
- Atrial Fibrillation: Hyperthyroidism can cause rhythmic dysfunction of the heart.
Diagnosis and Treatment of Thyroid Disorders
Diagnosis
The diagnosis of thyroid disorders consists of:
- History: Your doctor will ask you questions about the severity and duration of your symptoms. You may also be asked about other medical conditions you have and the history of thyroid disorders in your family.
- Examination: Your doctor will examine you for signs and symptoms of thyroid disorder. Your neck may be examined, as well as your heart rate, blood pressure, hands, and other body parts with symptoms.
- Blood Tests: Your thyroid hormone levels, T3 and T4, and Thyroid Stimulating Hormone(TSH), a pituitary hormone that regulates the thyroid gland’s hormone production, will be checked. Low levels of Triiodothyronine(T3) and Thyroxine (T4) with high TSH indicate hypothyroidism, while high T3 and T4 with low TSH indicate hyperthyroidism.
- Thyroid Gland Ultrasound: A thyroid gland ultrasound checks its size, shape and echotexture and assesses the presence of thyroiditis-related changes.
Treatment
The treatment options for thyroid disorders are dependent on the diagnosis of the condition, either hypothyroidism or hyperthyroidism.
Hypothyroidism treatment modalities include:
- Medical Therapy: Medication like Levothyroxine may be given as a hormone replacement for your thyroid hormone insufficiency
- Surgical Therapy: If the thyroid gland is huge (goitre), a thyroidectomy (surgical removal of the thyroid gland) may be required. However, this procedure is less standard in hypothyroidism than in hyperthyroidism.
Hyperthyroidism treatment modalities include:
- Medical Therapy:
- Anti-thyroid medications such as carbimazole, methimazole, and propylthiouracil are used to reduce thyroid hormone production and release.
- Beta-Blockers: These medications are used for treating hyperthyroidism symptoms such as rapid heartbeat, anxiety, and tremor.
- Surgical Therapy: Total or subtotal removal of the thyroid gland (thyroidectomy) may be done if medical treatment does not give the desired result or in the case of a massive goitre (enlargement of the thyroid gland)
- Radioiodine Therapy: Treatment with radioactive iodine taken orally. It helps to reduce the size of the thyroid gland and, in turn, the production of thyroid hormones.
When to See a Doctor
If you have symptoms related to either hypothyroidism or hyperthyroidism, you should seek the professional advice and counsel of a medical doctor immediately. Your doctor will help you understand the symptoms better and manage them appropriately.
Thyroid Treatment in Singapore
The diagnosis, treatment and management of thyroid disorders are within the purview and expertise of endocrinologists. It is important to seek an expert’s professional help and counsel when having thyroid disorder symptoms. Consultant endocrinologists in Singapore have the necessary knowledge to manage thyroid disorders efficiently.
To better understand your thyroid symptoms, get a diagnosis, and learn the most appropriate management option, book an appointment with Harmony Thyroid, Endocrinology and Diabetes Centre to consult with Dr Vikram Sonawane, a Senior Consultant Endocrinologist with experience and expertise in managing thyroid disorders.
