Published: August 16, 2024
The thyroid is a small, butterfly-shaped glad at the base of your neck, near your collarbones. While this organ is little, it’s got big responsibilities, including regulating important hormone levels, your heart rate and your metabolism. The two main thyroid disorders are hyperthyroidism and hypothyroidism. Both conditions affect thyroid function. Think of them as opposites: In hyperthyroidism, your thyroid makes too much hormone. In hypothyroidism, too little thyroid hormone is produced. Women are more likely to be affected than men, as 1 in 8 women will experience a thyroid issue in her lifetime.
“Thyroid problems in general can be difficult to diagnose, because the symptoms can be so mild they are unnoticeable, and because they mimic other conditions,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. Some common symptoms include:
Thyroid hormones affect almost every organ system in the body, from your bones to your central nervous system. With hypothyroidism, you can experience:
It can be difficult to link some of the above symptoms to a thyroid issue. Your health care provider may run some blood tests to check your hormone levels.
“Make sure your primary care provider has all your health information, including symptoms and family history,” Dr. Brandon said.
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Thyroid function can be determined with a blood test. Thyroxine (T3) and triiodothyronine (T4) are the hormones the thyroid makes. Blood tests can show if you have an underactive thyroid (hypothyroidism).
Thyroid stimulating hormone (TSH) is a hormone made in the pituitary gland that tells the thyroid how much T4 and T3 to make.
A high TSH level may mean you have hypothyroidism, or an underactive thyroid. This means that your thyroid isn’t making enough hormone. As a result, the pituitary system keeps making and releasing TSH into your blood.
If the TSH test results are not normal, your doctor may perform least one other test to help find the cause of the issue.
T4 test
A high blood level of T4 may mean you have hyperthyroidism. A low level of T4 may mean you have hypothyroidism.
In some cases, very high or low T4 levels may not mean you have thyroid problems. If you are pregnant or are taking oral contraceptives, your thyroid hormone levels will be higher. Severe illness or the use of corticosteroids (medicines to treat asthma, arthritis, skin conditions, and other health issues) can lower T4 levels.
T3 testing
With hyperthyroidism, your T4 level may be normal, but you may have a T3 test to confirm the diagnosis. Sometimes T4 is normal but T3 is high, so measuring both T4 and T3 levels can be useful in diagnosing thyroid issues.
Thyroid antibody test
Measuring levels of thyroid antibodies may help diagnose an autoimmune thyroid disorder like Hashimoto disease, the most common cause of hypothyroidism. Thyroid antibodies are made when your immune system attacks the thyroid gland.
Other tests may include imaging, such as a thyroid scan, which uses radioactive iodine to help the doctor see your thyroid clearly. This test can show thyroid nodules, which are small, often harmless lumps on the gland. It can also detect inflammation, an enlarged thyroid and other abnormalities.
Testing also can show signs of thyroiditis, or an inflammation of the gland. There are several types of thyroiditis, but the most common is Hashimoto disease.
An underactive thyroid gland affects your whole body. There is no cure for thyroid disorders, so the symptoms are treated as needed. Treatment for hypothyroidism symptoms usually includes taking a levothyroxine pill (Levo-T, Synthroid) every day. It boosts thyroid hormone production, keeps hormones in a healthy range and relieves symptoms of hypothyroidism. Most patients feel better one to two weeks after starting treatment.
Your health care provider usually will test you every year to check thyroid function.
You’ll likely start to feel better one or two weeks after you begin treatment. Treatment with levothyroxine likely will be lifelong. Because the dosage you need may change, your health care provider may check your TSH level every year.
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