Ask a Doc: Thyroid Awareness

January is Thyroid Awareness Month, a time when the medical profession focuses attention on that tiny gland located in the lower front part of your neck. While small in comparison to many organs in your body, the thyroid gland is a complex and irreplaceable organ with unique functions. Emily Haly, M.D., of the Boca Grande Health Clinic, explains what role your thyroid plays in your overall health and wellness, and why it’s so important to pay attention to it.

Do you have a question for us? If so, please send questions to the Clinic at https://www.bghc.org/contact or to the Boca Beacon and we will answer them.

What is the thyroid, and what is its role in the body?

The thyroid is a small butterfly-shaped gland that measures about 2 inches long and sits at the base of your neck, just below the Adam’s apple. Its main job is to produce hormones (T3 and T4) that control your body’s metabolism. But it does so much more. Thyroid hormones help regulate breathing, heart rate, menstrual cycles, body temperature, blood pressure, and even your mood. An imbalance in thyroid hormone levels can negatively affect your bodily functions. Left untreated, a thyroid imbalance can lead to many significant problems including heart disease, goiter, pregnancy problems and other life-threatening conditions.

What are the common thyroid disorders?

When the thyroid is functioning optimally, the body operates efficiently, much like a well-tuned car engine. There are two main disorders – hypothyroidism, where the thyroid doesn’t make enough hormones, and hyperthyroidism, where too many hormones are produced. Graves’ disease is the most common cause of hyperthyroidism, affecting about 70 percent of people with an overactive thyroid. An overactive or underactive thyroid can disrupt the body’s equilibrium, just as engine-related issues can lead to poor car performance. Either too high or too low can be dangerous for your health.

How can I tell if something is going on with my thyroid?

It is important to consider thyroid disease when someone comes in because it’s almost always on the differential. Thyroid hormones affect nearly every organ in your body, even your heart. Thyroid disease can present with just about any symptom – you name it. Depending on whether your thyroid is too high (overactive) or too low (underactive), it could be weight gain or weight loss, diarrhea or constipation, fatigue or anxiety. But the nice thing about it is that it’s easy to test for with a simple blood test. A goiter is an enlargement on the neck and it’s visible to the eye. You see this in countries with iodine deficiencies or a lack of iodine in water, which is rare in developed countries since iodine is added to the water. It’s important to evaluate thyroid nodules with routine testing which usually includes blood work and an ultrasound of the nodule.

Often times women come in with weight gain, which can be related to their thyroid. Hashimoto’s disease can be associated with low thyroid levels, which need to be treated with thyroid medicine.  Sometimes patients come in with tachycardia, i.e., atrial fibrillation, or anxiety and it may be related to an overactive thyroid. It is important to evaluate the thyroid with bloodwork in these situations.

Who is most at risk?

Thyroid disorders can affect anyone, but you’re at an increased risk of hypothyroidism, when the thyroid gland doesn’t make enough thyroid hormones to meet your body’s needs, if you are a woman, have a family history of thyroid disease, have had radiation to the neck or chest or have an autoimmune disease, such as type 1 diabetes or celiac disease. Some medicines can affect your thyroid as well. According to the American Thyroid Association, women are five to eight times more likely than men to develop thyroid disease. More than 12 percent of women will develop a thyroid disorder during their lifetime. At the Boca Grande Health Clinic, we check thyroid levels every year in women as part of their annual physical.

How is thyroid disease detected?

A simple blood test will show your healthcare provider how well your thyroid gland is working. You don’t need to do anything special to prepare for the test; fasting is not required. A full test panel measures the levels of thyroid hormones in your blood. The most common test is called TSH (Thyroid-Stimulating Hormone). If your TSH is too high, it might mean you have hypothyroidism, and if it’s too low, it might indicate hyperthyroidism. T3 and T4 levels are also measured to get a complete picture.

Additionally, more specific testing may be ordered when your thyroid is producing too many hormones. These include ultrasound, imaging tests and nuclear medicine scans.

How do you treat thyroid disease?

Thyroid disease is generally pretty easy to treat. If it’s low, which is the most common, it’s usually treated with a low-dose daily medication. This medicine replaces the missing thyroid hormones, helping you feel better. You must take your thyroid medicine as directed, without skipping doses. It is important to keep your levels in the normal range.

If you have overactive thyroid, or hyperthyroidism, your body’s metabolism is in over-drive. Treatment can include antithyroid medicines to block or slow down the effects of the extra thyroid hormone, radioactive iodine therapy to reduce thyroid activity – or a combination of these. Sometimes surgery to remove part or all of the thyroid gland is the best course of treatment.

Early detection and proper management are key to living a healthy life with these conditions. If you suspect any issues with your thyroid, please talk to your doctor for proper evaluation.

Do you have a question for us? If so, please send questions to the Clinic at https://www.bghc.org/contact or to the Boca Beacon and we will answer them.

About the Author

Private: Emily Haly, M.D.

Dr. Emily Haly (pronounced hail-ee) joined the Clinic full time in November 2022. Board-certified in internal medicine, she received her bachelor’s degree from Southern Methodist University and her medical degree from the Medical University of South Carolina, where she also completed her internship and residency. She brings some two decades of medical experience to the […]