Do You Know the Signs of Thyroid Disease?

As we age our metabolism naturally slows down and many of us can’t eat the way our younger selves used to without seeing it reflected on the scale. But if you’ve struggled with your weight for years or you’ve just recently unexpectedly gained or lost some weight, there may be more than just age to blame.

The thyroid gland is a butterfly-shaped gland that is normally located in the lower front of the neck. The thyroid’s main role in the endocrine system is to regulate your metabolism, or your body’s ability to break down what we eat and drink and convert it to energy, by producing two hormones, T3 (triiodothyronine) and T4 (thyroxine). When your thyroid produces more or less of these two hormones, it can easily trigger significant weight loss or, more commonly, weight gain.

More than 12 percent of Americans develop a thyroid condition in their lifetime and up to 60 percent of those sufferers are undiagnosed, according to the American Thyroid Association. Additionally, women are five to eight times more likely than men to have thyroid issues.

While there are multiple conditions that affect the thyroid, the two most common are hyperthyroidism (overactive) and hypothyroidism (underactive). The two conditions share similar symptoms, but Jessica Brown, M.D., an OB/GYN and physician on the medical staff at Texas Health Arlington Memorial, says there are a few key symptoms that are specific to one or the other.

“Hypothyroidism is associated with nonspecific symptoms including fatigue, constipation, cold intolerance, muscle cramps, weight gain, hair loss, depressed mood, low energy, menstrual irregularity and dry skin,” she explains. “Symptoms for hyperthyroidism include heat intolerance, tachycardia [irregular heartbeat], enlargement of the thyroid gland, exophthalmos [bulging of the eye anteriorly], failure to gain weight or weight loss, anxiety, tremor, emotional instability, increased sweating, diarrhea and absent or irregular menses.”

In both instances, if you suspect you are having issues with your thyroid, your physician will physically check your thyroid gland and look for any changes, such as smooth or dry skin, swelling, slower or faster reflexes, tremor or a slow or rapid heart rate. Then they will follow up with blood tests, the TSH (thyroid-stimulating hormone) test and T4 tests, to confirm or deny any suspicions they may have.

The TSH test measures how much of the hormone thyroxine (T4) the gland is being asked to make by the body. An abnormally high TSH signals hypothyroidism. The T4 tests measure how much T4 is in the blood and is available to be used by cells. A high level of T4 plus a low level of TSH commonly signals hyperthyroidism.

Although most thyroid diseases are life-long conditions, they can be managed. For hypothyroidism, you will be prescribed a replacement for the amount of hormone your thyroid can no longer make. For hyperthyroidism, treatment can range from antithyroid drugs, which block your thyroid’s ability to make new thyroid hormone, to radioactive iodine which targets and destroys thyroid cells, all the way up to surgical removal of all or most of your thyroid.

The direct cause of thyroid-related issues is unknown and there are no definitive ways to prevent thyroid disease, but there are things you can do to promote a healthier thyroid gland.

Ask for a thyroid collar during X-rays

Before you undergo  X-rays, especially those that involve the head, neck, spine or chest such as dental X-rays, ask the technician or nurse to place a thyroid collar on your neck. The collar looks like the neck part of a turtleneck sweater and is heavy and lined with lead, just like the “jacket” that is placed over your chest during a dental X-ray.

This collar protects your thyroid from any excess radiation exposure.

Eat less soy

While soy has long been touted as a healthier protein alternative, recent research published in the journal Nutrients supports that it may have an unhealthy effect on your thyroid gland. This is especially true for those who already have a compromised thyroid and take medication for it, because soy interferes with the absorption of levothyroxine, a popular medication used to treat hypothyroidism.

Check your thyroid

Of course, a regular visit with your physician can help you keep an eye on your thyroid health, but a visual check of your thyroid on your own can help detect issues before your next visit with your doctor.   

All you need is a glass of water and a mirror. Focusing on the lower front area of your neck, above the collarbones and below the voice box, tip your head back just enough to where you can still see your neck. Take a drink of water and swallow, and as you swallow look at this area on your neck. Check for any bulges or protrusions as you swallow. You may want to repeat this multiple times to be sure. If you do see anything suspicious, see your physician.

Stop smoking

Cigarettes have a variety of toxins that can affect your overall health, but also your thyroid. Thiocyanate, commonly found in cigarettes, disrupts iodine uptake, which can block the production of thyroid hormones. Smoking can also cause elevated T4 and decreased TSH levels.

Consider taking a selenium supplement

Selenium is a nutrient commonly found in specific proteins, and the thyroid has the highest concentration of selenium in the adult body. Even if you’re getting enough selenium through your diet, adding a supplement can still boost your immune system. If you and your doctor decide a selenium supplement is a good choice, opt for selenomethionine versus sodium selenite because it is absorbed better by the body.

Getting to know your individual thyroid health, risk factors and lifestyle changes can help you lessen your risk of issues, but keep in mind that nothing is a sure bet, especially if you have a family history, take prescription medications like lithium or amiodarone, or have experienced extensive radiation therapy to the head or neck. Talking to your physician about your risk factors and visiting them regularly can help keep an eye on any issues as they occur.

Texas Health is dedicated to serving you and your family throughout a lifetime of changing medical needs. Find a Texas Health Physicians Group doctor near you to get the ball rolling. 


  • Amrita says:

    Thank you. This was excellent information.

  • Carolyne Benton says:

    Years ago I had hyperthyroidism and had the Radio active Iodine. Treatment.
    Take synthroid daily.
    At my annual check up each year they test with THS test.
    Should I take the selenium supplement ?
    No Dr. Has ever suggested that.
    It is news to me.
    Thank you
    Carolyne Benton

  • Judy Penick says:

    My best friend sent me this info, she works for Texas Health. I have an appointment in 4 days because I have many of the symptoms. I am so thankful for this article. I believe I have had these symptoms for years but have recently gotten worse. Thank you for this info.

  • Krtexas says:

    That is the best article I have seen on Thyroid health. Very important. I tell my lived ones to get the blood test with their annual physical. I could have lost my job while in my 30s because of severe short term memory loss and not being able to drag myself out of bed in the morning after 10 pluss hours of sleep. I was too tired to eat supper and swelling up from fluid retention in my face and neck.

    One friend said go to the doctor, you might have high blood pressure. Another said go to the doctor you might have low Thyroid. Sure enoug Levothyroxine was the remedy until in my 60s when Liothyronnine was added.

    For 30 years I have questioned dental assistants concerning radiation possibly damaging my Thyroid gland and have normally been instructed to NOT pull up the chest sheild over my neck. From now on I will inquire of the dentist before scheduling an appointment. I have wondered if the increase of dental care (very needed increase) has contributed the the increase of Thyroid problems. Glad you wrote abou the X-ray shield.

  • Nancy says:

    When I was young I was hyperthyroid and could eat anything I wanted and was very thin. Suddenly in my 60’s I began to gain weight for the first time in my life. My hair fell out in clumps like I was taking chemotherapy, and my skin was so very dry. It took a year for my doctor to discover I was hypothyroid. My T4 was normal, but my T3 was very low. For some reason my body is not converting T4 to T3 so I need to take Armour thyroid, a natural thyroid medication which has both T4 and T3, instead of the synthetic medications that only contain T4. Doctors should do a blood test to test for T3 as well as T4. My hair stopped falling out almost immediately after starting the medication.

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