Kimberly Dorris lost a few pounds, then regained them, but chalked it up to a stomach bug. She had trouble sleeping and concentrating, but attributed it to the stress of working two jobs. She sweat a lot, but that's typical in Arizona. Her hands shook, but she was drinking loads of coffee and Diet Coke. "I had some classic symptoms," Dorris says, "but never connected it with thyroid issues." But after a routine screening in 2007, the now-48-year-old executive director of the Graves' Disease & Thyroid Foundation was diagnosed with Graves' disease, which like many thyroid problems, is often overlooked. Here are 10 reasons you might have a problem with yours:
1. You don't really know what your thyroid is.
The thyroid is a gland just under the Adam's apple that regulates your heart beat, how fast you burn calories and other metabolic functions. "There are [thyroid hormone] receptors in pretty much every organ" of the body, says Dr. Chienying Liu, an endocrinologist at the University of California-San Francisco Medical Center's Thyroid Clinic. That's why when it's malfunctioning, its effects are so wide-ranging, contributing to heart, muscle, bone, fertility and other severe health problems if left untreated.
2. You're a woman.
About 20 million Americans have some form of thyroid disease, according to the American Thyroid Association. The autoimmune disorders Hashimoto's disease and Graves' disease are common causes of hypothyroidism (when the thyroid produces too little thyroid hormone) and hyperthyroidism (when the gland produces too much hormone), respectively. Women are up to eight times more likely than men to have thyroid problems, with 1 in 8 women expected to develop an issue in her lifetime. Catching thyroid disorders is particularly important in pregnant women, who are at higher risk for miscarriage, preterm delivery and developmental problems in their children if left untreated, the ATA reports.
3. It runs in the family.
Talk to your parents, siblings, grandparents and other blood relatives about their history of thyroid troubles, recommends Dorris, whose cousin had thyroid cancer. "Thyroid issues can cluster in families," she says. The more relatives you can point to with thyroid issues, the stronger your case for a thyroid dysfunction screening, she says.
4. Your scale is tipping.
With hypothyroidism, your metabolism slows, which can pack on the pounds. With hyperthyroidism, your body may use too much energy, which can cause you to lose weight. But the reverse can happen too, Liu says, since people with hypothyroidism may not often feel like eating, while people with hyperthyroidism often have an increased appetite and may overcompensate. "Some even say they are hungry all the time," she says.
5. You're suddenly out of shape.
Someone with hyperthyroidism may once have enjoyed five-mile jogs with no problem "and now can't go beyond two miles," often due to the shortness of breath and muscle weakness associated with the condition, Liu says. While fatigue tends to be associated with hypothyroidism, it can be a symptom of hyperthyroidism, too, she says. People with hyperthyroidism may also sweat a lot and have little tolerance for heat (while people with hypothyroidism often feel cold), says Dr. Hossein Gharib, a professor of medicine at the Mayo Clinic College of Medicine and past-president of the American Thyroid Association. All are symptoms that won't make even the fittest Americans want to hit the gym.
6. You can't go -- or stop going -- to the bathroom.
Just as hypothyroidism slows the metabolism, it also slows down the gastrointestinal tract, Liu says. In other words, it can be a recipe for constipation. In hyperthyroidism, the opposite is often true: Sufferers may become all-too-familiar with the toilet. But just as with many of the other thyroid symptoms, bowel troubles are often signs of non-thyroid related problems, Gharib says. Even though the thyroid may be a cause of weight changes, GI issues, fatigue and depression, he says, "the majority of people with these symptoms do not have thyroid problems."
7. Your eyes and ears aren't the same.
People with Graves' disease might find their eyelids swollen and their eyeballs protruding, which could be due to immune cells targeting the eye muscles in a similar way they target the thyroid gland, according to the University of Michigan Kellogg Eye Center. Gharib says Graves' disease patients may also have red eyes, irritation, tearing and double vision. A minority of people with hypothyroidism, on the other hand, may experience hearing loss, although it's likely reversible with treatment, Liu says.
8. You have a lump in your throat.
Gharib encourages patients to "check the neck." More specifically, take a sip of water while looking in the mirror. If the area just under your Adam's apple appears lumpy while drinking, tell your doctor, who may perform an ultrasound or biopsy, since lumpy, hard or enlarged thyroid glands can be a sign of cancer. A hoarse voice and difficulty swallowing are also red flags, although Liu says thyroid cancer is usually "silent" and doesn't show symptoms. The good news? At least 85 percent of thyroid nodules are benign, she says, and those that are cancerous are treatable, usually with surgery.
9. You're a grouch.
Patients with hyperthyroidism may not always notice they're more cranky than usual, but their spouses or family members often report it, Liu says. They can also feel more agitated and nervous. Depression isn't uncommon, either, in people with both overactive and underactive thyroids. Mood changes, however, can sometimes be misdiagnosed as just that, while the thyroid is left untreated, Dorris says.
10. All of the above.
The more signs and symptoms you have, the more likely your thyroid is the culprit. "What raises the index of suspicion is if you have a constellation of symptoms," Liu says. Even if you just have one or two, ask your primary care physician for a TSH test, a simple blood test that measures how much thyroid hormone your gland is producing. If your thyroid is overactive or underactive, it can be treated -- often with medications and sometimes with surgery. "It's so important for people to know their bodies and know what's normal for them," says Dorris, who is now off antithyroid medications and monitoring her thyroid closely with her doctor. "If there's something out of the ordinary, go to the doctor and get it checked out."