Thyroid Problems and Related Symptoms
Medically reviewed by Do-Eun Lee, MD
Thyroid problems occur when your thyroid gland (a small organ in the front of your neck) does not produce normal levels of thyroid hormones. Because these hormones control many vital functions in your body, problems can result when levels are disrupted. These hormones affect your brain and organ function, bone growth, heart rate, and muscle function.
Thyroid problems can be linked to too much thyroid hormone. This can cause symptoms like higher metabolism, weight loss, fatigue, racing heartbeat, hair loss, and nervousness.
Thyroid problems can also involve disorders that cause too little thyroid hormone. This can trigger symptoms like weight gain, slow heart rate, slow movement, and depression.
This article describes the many thyroid problems, their causes, symptoms, and treatments.
Most Common Thyroid Problems
The most common thyroid problems include the following:
Graves' Disease
Graves' disease is an autoimmune disease in which your immune system attacks your thyroid. This causes hyperthyroidism (producing more thyroid hormones than your body needs). Graves' disease is the most common cause of hyperthyroidism.
Having the following risk factors can increase your chances of developing Graves' disease:
Being a woman
Being older than age 30
Having a family history of Graves' disease or Hashimoto's disease
Having other autoimmune disorders like rheumatoid arthritis or vitiligo
Using nicotine products
Thyroiditis
Thyroiditis (inflammation of the thyroid gland) can occur as a result of the following factors:
Viral infections
Some medicines
Post-pregnancy reactions (postpartum thyroiditis)
Reaction to treatment with radioiodine therapy for Grave's disease
Depending on the cause of thyroiditis, either hyperthyroidism or hypothyroidism (too little thyroid hormone) will result.
Hashimoto's Disease
Hashimoto's disease (or Hashimoto's thyroiditis) is an autoimmune disease in which your immune system attacks your thyroid. It causes your thyroid to become inflamed.
Hashimoto's disease is the most common cause of hypothyroidism. The inflammation makes your thyroid incapable of generating enough thyroid hormones to support your bodily functions.
People with Hashimoto's disease tend to have the following risk factors:
Being a woman between the ages of 30 and 50
Family history of Hashimoto's disease
Having another autoimmune disease, including the following: celiac disease, lupus, rheumatoid arthritis, Sjögren's disease, and type 1 diabetes
Congenital Hypothyroidism
A baby can be born without a thyroid or with only a partly formed thyroid. Some babies are born with ectopic thyroid (a thyroid in the wrong place). Hypothyroidism can also occur in babies born with thyroid cells or enzymes that are defective and hinder the production of thyroid hormones.
Risk factors for congenital hypothyroidism include the following:
Advanced maternal age
Gestational thyroid disease
Gestational diabetes mellitus
Gestational anxiety
Gestational drugs
Radiation exposure during gestation
Family history of thyroid disease
Low birth weight
Macrosomia (high birth weight)
Premature birth
Post-term birth
Birth to twins or other multiples
Thyroid Cancer
Thyroid cancer is a cancer that starts in the cells of your thyroid gland. It is often curable if it is treated before it spreads to other areas.
Thyroid cancer risk factors include:
Being a woman
Being of Asian descent
Being between 25 and 65 years old
Having a family history of thyroid cancer
Having prior exposure to radiation of the neck and head
Having certain genetic conditions, including the following: multiple endocrine neoplasia, type 2A syndrome, multiple endocrine neoplasia, type 2B syndrome, and familial medullary thyroid cancer
Being obese or overweight
Consuming too much or too little iodine in your diet
Least Common Thyroid Problems
Some of the least common thyroid problems include the following:
Overactive Thyroid Nodules
While thyroid nodules, or lumps in your thyroid are very common and usually benign (noncancerous), a minority of these lumps can cause problems. Issues occur when one of these lumps becomes overactive and produces too much thyroid hormone, causing hyperthyroidism.
The cause of thyroid nodules is unknown. The most significant risk factors for overactive thyroid nodules include the following:
Increasing age
Living in areas of iodine deficiency
Smoking
Noncancerous Tumor of the Pituitary Gland
Rarely, a benign tumor of your pituitary gland (a gland located at the base of your brain) can cause hyperthyroidism.
The following risk factors are linked to the development of noncancerous tumors of the pituitary gland:
Family history of tumor of the pituitary gland
Certain genetic syndromes: multiple endocrine neoplasia, type 1 (MEN1), multiple endocrine neoplasia, type 4 (MEN4), McCune-Albright syndrome, Carney complex, and familial isolated pituitary adenoma (FIPA)
Consuming Excess Iodine
Most healthy people can tolerate high iodine intake. However, it is possible to develop thyroiditis as a result of eating too many foods that contain iodine. This type of reaction is very rare.
A reaction to excess iodine is typically limited to people who already have a problem with their thyroid.
Symptoms Associated With Thyroid Problems
Graves' Disease Symptoms
Symptoms of Graves' disease include the following:
Weight loss despite an increased appetite
Irregular or rapid heartbeat
Irritability or nervousness
Fatigue or trouble sleeping
Muscle weakness or shaky hands
Abnormal sweating or trouble tolerating heat
Diarrhea or frequent bowel movements
Goiter (an enlarged thyroid gland)
Thyroiditis Symptoms
Thyroiditis symptoms can vary because the condition includes several types of disorders from too much or too little thyroid hormone. When thyroiditis leads to hyperthyroidism, possible symptoms include the following:
Weight loss
Nervousness, anxiety, or irritability
Trouble sleeping
Fatigue
Rapid heart rate
Muscle weakness
Tremors
Loose stools or diarrhea
When thyroiditis leads to hypothyroidism, possible symptoms include the following:
Weight gain
Fatigue
Dry skin
Muscle aches
Constipation
Depression
Hashimoto's Disease Symptoms
Symptoms of Hashimoto's disease may not occur until the disease progresses. They can include the following:
Fatigue
Weight gain
Difficulty tolerating cold
Constipation
Joint and muscle pain
Dry skin
Dry, thinning hair
Irregular or heavy menstrual problems
Fertility problems
Slowed heart rate
Congenital Hypothyroidism Symptoms
Symptoms of congenital hypothyroidism include the following in babies:
Neonatal jaundice (yellow eyes or skin)
Constipation
Sleeping more often or longer than usual
A large fontanelle (soft spot) on the baby's head
Large belly with protruding navel
Weak or floppy muscle tone
Cool, pale skin
Swelling around the eyes
Thyroid Cancer Symptoms
Common signs of thyroid cancer include the following:
A fast-growing lump in your neck
Swelling in your neck
Pain that originates in the front of your neck and goes up to your ears
Trouble breathing and/or swallowing
Voice changes, including hoarseness, that do not improve
A persistent cough unrelated to a cold
Thyroid Nodule Symptoms
Symptoms of thyroid nodules are uncommon. They may occur when a nodule grows large and causes the following problems:
Pain
Hoarseness
Interference with normal swallowing or breathing
Noncancerous Pituitary Tumor Symptoms
Symptoms of pituitary tumors that produce too much thyroid hormone may cause the following symptoms:
Irregular heartbeat
Weight loss
Shakiness
Trouble sleeping
Frequent bowel movements
Sweating
Excess Iodine Symptoms
Symptoms of consuming too much iodine include the following:
Goiter
Increased metabolism
Weight loss
Fast or irregular heartbeat
Hand tremors
Irritability
Fatigue
Sweatiness
Who Gets Thyroid Problems?
While thyroid problems can affect anyone, women are 5 to 8 times more likely than men to experience them.
The following thyroid problems affect more women than men:
Disorders that cause hypothyroidism
Disorders that cause hyperthyroidism
Postpartum thyroiditis
Goiter
Thyroid nodules
Thyroid cancer
How Do You Know If You Have Thyroid Problems?
You can only know you have thyroid problems by consulting with your healthcare provider about symptoms. It is not possible to diagnose thyroid problems yourself because many symptoms caused by thyroid problems also occur in other medical conditions.
Your healthcare provider can determine whether you have thyroid problems by using the following diagnostic tools:
A thorough clinical evaluation with a medical history of risk factors and a physical exam that includes feeling the area around your thyroid for lumps, bumps, or enlarged lymph nodes in your neck.
One or more of the following blood tests that measure thyroid hormone levels in their different forms may be performed:
Thyroid-stimulating hormone (TSH) test (considered the best way to test thyroid function initially)
Total T3/total triiodothyronine
Free T3/free triiodothyronine
Thyroglobulin (TG)/thyroid-binding globulin (TBG)
Thyroid peroxidase (TPO) antibodies /antithyroid peroxidase antibodies
Thyroglobulin antibodies /antithyroglobulin antibodies
Thyroid-receptor antibodies (TRAb)
Imaging tests to identify thyroid deterioration, enlargement, or nodules include:
Thyroid ultrasound uses sound waves to create images of your thyroid and identify whether a nodule is a cyst filled with fluid or a mass of solid tissue.
Thyroid scan uses a small amount of radioactive iodine or a similar substance while a special camera makes images of your thyroid on a computer screen showing the pattern of iodine uptake in your thyroid.
Radioactive iodine uptake test (RAIU) uses a radioactive iodine tracer and camera to examine your thyroid health and functioning by observing how much radioactive iodine your thyroid absorbs over a certain time (may be done with a thyroid scan).
Thyroid fine needle aspiration biopsy uses a very thin needle to remove cells and fluid from your thyroid, which are observed under a microscope to identify thyroid cancer.
How to Check Yourself for an Enlarged Thyroid
You can determine whether you have an enlarged thyroid, which can indicate a thyroid problem. To do so, follow these steps for performing a thyroid swallow test:
Stand in front of a mirror, focusing on the area around your thyroid gland, which includes the lower front area of your neck, above your collarbones, and below your voice box.
Tip your head back.
Take a drink of water and swallow.
Look at your neck as you swallow, checking for any bulges or protrusions in the area of your thyroid gland while you swallow.
Contact your healthcare provider if you notice any protrusions or bulges in this area.
Short-Term Treatment for Thyroid Problems
Short-term treatments generally involve thyroid medication. They may be used to treat temporary cases of hyperthyroidism or to achieve immediate results. During treatment, your healthcare provider monitors your progress to determine whether to continue with medication long-term, discontinue it, or pursue more permanent treatments.
The type of short-term treatment your healthcare provider advises depends on the type of thyroid problem present, its severity, and other factors like your age and medical conditions.
Hyperthyroidism
The goal of hyperthyroidism treatment, which is usually linked to Graves' disease or thyroid nodules, is to prevent your thyroid from producing too much thyroid hormone. Short-term treatments for hyperthyroidism involve the following:
Antithyroid drugs: Antithyroid drugs increase the ability of your thyroid cells to make new thyroid hormones. There are two antithyroid drugs used in the United States: Propycil (propylthiouracil) and Tapazole (methimazole), which is preferred because it works faster and has fewer side effects than Propycil.
Beta-blockers: Beta-blockers help control symptoms of hyperthyroidism like rapid heart rate, nervousness, and shakiness. The following beta-blockers, among others, may be used: Inderal (propranolol), Corgard (nadolol), and Lopressor (metoprolol).
Hypothyroidism
The goal of hypothyroidism treatment, which can be linked to Hashimoto's disease or iodine deficiency, is to produce the hormones thyroxine (T4) and triiodothyronine (T3). Short-term treatments for hypothyroidism include the following:
Synthroid, Levoxyl, Unithroid, Tirosint (levothyroxine): regarded as first-line treatment for hypothyroidism
Cytomel, Triostat (liothyronine)
In subclinical hypothyroidism or mild thyroid failure, a course of watchful waiting (a postponement of treatment while your condition is monitored) may be advised to see if thyroid hormone levels normalize without treatment.
Thyroid Cancer
Thyroid cancer treatment depends on the stage of your cancer and other characteristics concerning your health and medical condition. Short-term treatment for thyroid cancer includes the following:
Watchful waiting: Watchful waiting postpones treatment while your condition is monitored for changes by a healthcare provider.
Thyroid hormone therapy: Thyroid hormone therapy may be used to remove or block thyroid hormones to stop the growth of cancer cells.
Targeted therapy: Targeted therapy uses drugs that identify and attack cells that promote the growth of thyroid cancer tumors. These medications include: Caprelsa (vandetanib), Cometriq (cabozantinib-S-malate), Gavreto (pralsetinib), Lenvima (lenvatinib mesylate), Mekinist (trametinib dimethyl sulfoxide), Nexavar (sorafenib tosylate), Retevmo (selpercatinib), and Tafinlar (dabrafenib mesylate).
Chemotherapy: Chemotherapy drugs can be administered orally or by injection. They are used to slow or kill cancer cells in your thyroid and other areas.
Learn More: An Overview of Thyroid Disease Treatments
How to Manage Chronic Thyroid Problems
Managing chronic thyroid problems varies based on the cause of your problems, the severity of your condition, and factors like your age and other medical conditions. For most people, it is possible to lead a normal, healthy life with proper treatment of chronic thyroid problems.
Chronic thyroid problems can be treated with long-term use of thyroid medication to restore normal function. The following treatments may also be used to treat these problems:
Radioactive iodine treatment (RAI): RAI, also known as radioiodine ablation, involves taking a dose of iodine 131 (radioactive iodine) to ablate, or destroy, all or part of your thyroid's ability to make thyroid hormone when the iodine is absorbed by your thyroid.
Thyroidectomy: A thyroidectomy is the surgical removal of all or part of your thyroid gland. It is the main treatment for most thyroid tumors and may be appropriate for pregnant or nursing people or those who have young children and want to avoid radiation exposure from RAI for their family members.
Lifestyle changes to avoid inflammation and stress include:
Get quality sleep nightly.
Engage in light to moderate exercise daily.
Reduce refined sugars and processed foods.
Limit your intake of cruciferous vegetables like cabbage and broccoli, which can interfere with thyroid hormone production.
Reduce stress.
Maintain a healthy body weight.
Learn More: Coping With Symptoms of Thyroid Disease
Summary
Thyroid problems affect more than your thyroid. Because thyroid hormones control so many functions in your body, any problem that affects your thyroid gland can have an impact on your general health.
Know your risk factors and whether you are more likely to have these problems based on family history or other factors. Symptoms of thyroid problems can often be confused with symptoms of other health problems. This can lead to a delay in treatment.
Getting annual exams can help your healthcare practitioner assess your thyroid for signs of problems that you may miss. With the right treatment, most thyroid problems can be treated so you can live a normal life.
Read the original article on Verywell Health.