Is It Time To Get Your Thyroid Checked?

How to know when to request thyroid tests

Butterfly-shaped thyroid glandIn our new Butterfly Club support group, we'll tackle every thyroid-related mystery you've told us you want solved, and demystify every function and health issue controlled by your butterfly-shaped thyroid gland.

That small gland shaped like a butterfly at the base of your neck has massive sway over your body and wellbeing. Approximately 20 million Americans have a thyroid condition such as hypothyroidism, with roughly 60 percent still unaware of it, according to the American Thyroid Association. It’s also a key organ that keeps us alive and functioning. As part of National Thyroid Awareness Month, we’re getting the lowdown on this powerhouse gland, with its wide array of functions and symptoms that can snowball when something’s gone awry.

Although your thyroid gland controls your metabolism, its role is not just about regulating weight, and it is often underestimated. It's involved in strength, muscle rebuilding, brain health, heart health, skin, nail, and hair health, mental health, fertility, sight, and more. It's key role in so many parts of your endocrine system is part of what makes diagnosing a thyroid disorder tricky, and all too often, prolonged. In this Butterfly Club support group and series, we'll demystify your often enigmatic thyroid gland, and answer all of your questions about every aspect of your thyroid health, with a new round table on a different topic of interest that you've been asking us about for every installment. First up: How to know when to get tested.

I'm feeling rundown, burned out, and having trouble losing weight. How do I know if it is my thyroid, or something else, like depression or chronic fatigue? Are there specific tells I can look for to let me know I need to get my thyroid tested?

That's a hard one to answer because your thyroid controls literally everything that happens in your body and mind. Very frustrating, right? Signs of a thyroid disorder could be as simple as your sleep cycle being off, your periods becoming irregular, or feeling depressed or anxious when you have no prior history of anxiety or depression. They could also be as dramatic as your blood pressure or your heart rate skyrocketing or plummeting. A thyroid hormonal imbalance can cause effects as subtle as slight variations in your cholesterol or your body temperature, or as dramatic as your blood sugar spiking or dropping, which can cause you to pass out. Because of its vast function, every body system that you can imagine can display signs of thyroid hormonal imbalances, and how varied they are unfortunately can cause people to go for years without receiving a diagnosis and treatment.

Your neurological, cardiovascular, and mental health are all affected when your thyroid is under or over-producing thyroid hormones, even if you only notice one of them changing. Depression and anxiety are common symptoms of thyroid hormonal imbalances, especially the kinds don't respond to therapy and medication. If you think you might have a thyroid issue, check our resources on hypothyroidism and hyperthyroidism to see if any of your symptoms match up. Here's another little clue that a lot of people get wrong: No one ever displays all of the symptoms of a thyroid condition. If you have a have one or two, it's enough of a reason to get tested. Often, people whose tests reveal thyroid issues have about half a dozen symptoms that are most pronounced, and then another half dozen that they identify after diagnosis that have been presenting more under their radar.

What can go wrong when you don't have enough thyroid hormones?

One way to think about hypothyroidism is that it puts your entire body and mind into a slow-motion setting. Your metabolism slows down and your body gets bogged down. Your energy use slows down, energy expenditure slows down, tissue repair is delayed, and tissue growth is stalled. Your brain slows down, your heart slows down, your head slows down, your kidneys slow down, your hair, skin, nails, and every system and function in your body slows down. That's why, if your thyroid hormones aren't working correctly, it’s serious, and something to have checked out right away, even though it can take many years for a thyroid hormone imbalance to seem obviously dangerous. You want to catch the deficiency before the massive slow-down gets to a point where it is life-threatening or causing irreversible consequences. The earlier you do and get treatment, the quicker you can get your mind and body back up to speed.

Conversely, if your thyroid is producing too many hormones, it can cause everything to speed up, which is equally dangerous if not caught and regulated in time. Symptoms of hyperthyroidism or an excess of thyroid hormones include accelerated appetite, weight loss despite eating more, bulging eyes, diarrhea, anxiety, rapid heartrate, and other signs of a body and mind in overdrive, which can be just as damaging and destructive if not caught speeding and brought back into balance.

Why does your butterfly-sized thyroid gland have such an enormous impact on your health and wellbeing?

Your thyroid is part of your endocrine system, which means that it is a hormone that is made in one part of your body that is then distributed throughout other parts to exert action and effect. It's also how your body communicates what's happening from one end to the other, and from one organ to another.

It's not as simple as your heart which simply pumps and pushes blood, for example, or the function of your lungs which allow you to breathe. Not to imply that those organs are unimportant or uncomplicated, but they each have a single mechanically recognized function.

Hormones are so diffuse, and they go throughout your body so widely, that we often don't recognize or appreciate their functions, because they are not as obvious. Unfortunately, what's not obvious is also often harder to catch and identify. Your thyroid is the only way your body can control what's happening in terms of where nutrition needs to go to be converted into energy, where energy needs to go to allow you to do the things you want to do, and to manage healing and recovery after injury or over-exertion.  

What if you suspect that you may have borderline or subclinical hypothyroidism, which means you have high TSH hormone levels, but they’re not quite high enough for your doctor to recommend treatment yet?

The American College of Endocrinology believes that it is important to listen to every patient, address their concerns and to use both objective and subjective measures to determine whether you will benefit or not from treatment. The medication used for thyroid treatment is very safe and has been around for a very long time, so there is no reason not to get tested and seek treatment if you suspect you may have a thyroid hormonal imbalance. It's better to get tested and realize it is not a thyroid issue like you thought then to wait and have to deal with the symptoms of a chronic illness that can be easily and safely treated once diagnosed.

We know that cholesterol, blood pressure, heart rate, sleep patterns and menstrual cycles are very objective measures of thyroid function and physiology. If you have things that are not feeling right in those areas, that are part of the syndrome of thyroid disease, you can use those to make your case for trying treatment. If you do that, and you understand the framework that your doctor provides as a reason not to prescribe medication yet, ask for a plan of action like repeated tests. Repeat evaluations and tests ensure that the single point in time that you were tested was not an error. Often, over time, health issues come to light that are not apparent in a single medical visit. 

If you believe you’re dealing with an undiagnosed thyroid condition, and you have seen a clinician who doesn't believe that you and is unwilling to attempt a trial of therapy, it's time to get a second opinion. Remember, you don't need any reason at all to stop seeing one doctor and to try a new one, and can switch anytime you feel like you are not being heard or respected during a medical appointment. You don't need any specific grievances to find another endocrinologist and see what they think. Trying a new doctor when you feel you are not receiving the care you need is usually not a case of, “Well, they didn't do what I wanted them to do, so I'm going to find someone who will.” It is more often that your previous doctor was not understanding or listening, so it makes sense to find one who will. That way, regardless of their opinion, you'll know you have a doctor who has your interests and concerns in mind, and who will work with you to help you until you feel better.

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