Here’s How to Tell if You Have a Hidden Thyroid Problem

Could you be suffering from hypothyroidism? Here are the symptoms to check for and how to cope if you do have a thyroid disorder.

The thyroid, a butterfly-shaped gland located in the base of your neck, tends to be a bit of an overachiever.  Its job is to produce hormones that are tasked with helping us use energy, stay warm and keep our brains, hearts, muscles, and other organs working optimally, according to the American Thyroid Association (ATA).

If your thyroid stops producing enough hormones (hypothyroidism) or produces too much (hyperthyroidism), you may need to be treated.

About 20 million Americans have some form of thyroid disease, notes the ATA, and women are much more likely to experience thyroid problems than men. (Learn more about your all-mighty thyroid gland and what is capable of.)

The symptoms of some thyroid disorders namely hypothyroidism can be subtle at first, while symptoms of hyperthyroidism can come on like gangbusters, explains John Woody Sistrunk, MD, an endocrinologist in Jackson, Mississippi and the chair of the American Association of Clinical Endocrinologist’s Thyroid Disease State Network. Getting an accurate diagnosis and starting treatment is key as when thyroid disease progresses untreated, it may increase the risk of heart disease, the brittle bone disease osteoporosis, and infertility. (Here are more health conditions that may be related to your thyroid.)

Hypothyroidism symptoms

Hypothyroidism is marked by an underactive thyroid gland that doesn’t make enough thyroid hormone to keep your body running properly. It is often caused by Hashimoto’s disease, an autoimmune condition in which your body misfires against its own thyroid gland, preventing it from doing its job. Other causes of a slow thyroid include the surgical removal of the thyroid gland or a history of radiation to the neck, he says.

Hypothyroidism symptoms may include:

  • Modest weight gain
  • Fatigue (especially as the day wears on)
  • Hair loss, particularly around the lateral edges of the eyebrows
  • Puffiness
  • Delayed reflexes
  • Depression
  • Forgetfulness

Many of these symptoms are vague, common and can be associated with a host of other conditions, he says. Dr. Sistrunk points out that the only way to know for sure that a sluggish thyroid is the culprit is through a blood test for thyroid-stimulating hormone (TSH) and (or) a test for the thyroid hormone thyroxine (known as T4).

The TSH test measures how much of the T4 your thyroid gland is being asked to produce. High TSH suggests your thyroid gland is being asked to make more T4 because there isn’t enough in your bloodstream. The T4 blood tests can gauge how much T4 is in the blood and available to get into cells. There are some things that standard thyroid testing won’t tell you. Family history is an important part of this discussion as oftentimes, autoimmune diseases cluster in families, says Dr. Sistrunk.

Hyperthyroidism symptoms

Hyperthyroidism is far less common than hypothyroidism, Dr. Sistrunk says. The most common cause of this condition is Graves’ disease, an autoimmune condition in which your immune system engages in friendly fire against your thyroid, causing it to become hyperreactive.

Hyperthyroidism symptoms may include:

  • Weight loss
  • Heat intolerance
  • Rapid heartbeat
  • Nervousness
  • Bulging eyes
  • Goiter or thyroid enlargement
  • Short, light menstrual periods

“People with hyperthyroidism may put their hand out and you can see a tremor,” he adds.

Blood tests along with a thorough physical examination can help establish a diagnosis of hyperthyroidism.  Blood tests that reveal a high level of thyroid hormone in the blood plus a low level of TSH indicate hyperthyroidism. Your doctor may also measure levels of thyrotropin receptor antibodies. If these antibodies are raised, it can confirm Graves’ disease. Sometimes, thyroid-imaging exams are also warranted, he says.

How are thyroid problems treated?

The good news is that thyroid problems are treatable, Dr. Sistrunk says. The first step is to get a proper diagnosis by an endocrinologist.

Parsippany, New Jersey-based endocrinologist Cheryl Rosenfeld, DO, also an adjunct clinical associate professor of medicine at the Touro College of Osteopathic Medicine in New York, agrees that medical treatment is the way to go. Everyone is searching for natural cures to get their thyroid to function better through diet or supplements, she says. But “there is no scientific proof that any specific diet or food will make your thyroid work better.”

Hypothyroidism is treated by replacing the amount of hormone that your own thyroid no longer produces, explains Dr. Sistrunk.

Hyperthyroidism is typically treated with radioactive iodine. Your thyroid needs iodine to make hormones. When radioactive iodine is given as a pill or liquid, it works by gradually shrinking your thyroid. This is also a standard treatment for thyroid cancers. It does have its share of downsides namely isolation. It’s important to avoid prolonged, close contact with others or several days after your treatment, Dr. Sistrunk says. “If this is not feasible, thyroid removal surgery may be an option,” he says.  After your thyroid is removed or destroyed with radioactive iodine, you will take synthetic thyroid hormones to mimic the functions of your thyroid gland.”

Many people will start to feel better right away, he says.  Follow-up is important. “I like to see patients in two to three months to recheck their lab to see if we are on the right track and go from there.”  Medication can be adjusted to make sure blood levels are where they should be, he says. Check out 18 more things doctors want you to know about your thyroid.

Medically reviewed by Tia Jackson-Bey, MD, on February 24, 2020

Denise Mann, MS
Denise Mann is a freelance health writer whose articles regularly appear in WebMD, HealthDay, and other consumer health portals. She has received numerous awards, including the Arthritis Foundation's Northeast Region Prize for Online Journalism; the Excellence in Women's Health Research Journalism Award; the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery; National Newsmaker of the Year by the Community Anti-Drug Coalitions of America; the Gold Award for Best Service Journalism from the Magazine Association of the Southeast; a Bronze Award from The American Society of Healthcare Publication Editors (for a cover story she wrote in Plastic Surgery Practice magazine); and an honorable mention in the International Osteoporosis Foundation Journalism Awards. She was part of the writing team awarded a 2008 Sigma Delta Chi award for her part in a WebMD series on autism. Her first foray into health reporting was with the Medical Tribune News Service, where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and Los Angeles Daily News. Mann received a graduate degree from the Medill School of Journalism at Northwestern University in Evanston, Ill., and her undergraduate degree from Lehigh University in Bethlehem, Pa. She lives in New York with her husband David; sons Teddy and Evan; and their miniature schnauzer, Perri Winkle Blu.