Your Thyroid Does a Lot: Is It Working Like It Should?

January 27, 2020
Within your neck, just below your Adam’s apple, sits a tiny, butterfly-shaped gland that carries out a lot of big jobs. The thyroid is part of the endocrine system—a sort of messaging network made up of hormone-producing glands that regulate organs and functions like metabolism, growth, sexual function, and even mood. Within this system, the thyroid affects several body functions that range from heart rate and growth to fertility and digestion. It’s the body’s metabolic control center. 

Quite a lot for one little gland. The thyroid works closely with the pituitary gland to make it all happen. The pituitary signals the thyroid when the body needs more or less of the three hormones it produces. For example, you get cold, and the pituitary signals your thyroid to warm up your body by releasing more of the hormones related to metabolic rate.

With all that to manage, it’s no wonder that disorders of the thyroid show up through a wide range of symptoms. Everyone has a thyroid, but women are much more likely to experience thyroid disorders, which likely is tied to hormone fluctuations related to menstruation, pregnancy, and menopause. Here are the signs of common thyroid disorders. 

Hypothyroidism, or underactive thyroid

Easily treated with medication, hypothyroidism results when your thyroid fails to produce the hormones it needs to work properly. It progresses slowly, causing symptoms like weight gain, slowed heart rate, and feeling cold even when others don’t. 

Most often, women notice that they have hypothyroidism because they’re tired and sluggish. Untreated hypothyroidism may also lead to memory problems, depression, and even elevated cholesterol. Most cases are mild, and a blood test will tell you where you stand. 

Hashimoto’s disease

If you have hypothyroidism, especially if you’re a middle-aged woman, the cause might be Hashimoto’s disease, which causes the immune system to target the thyroid gland, keeping it from producing enough hormones. 

Hashimoto’s disease progresses slowly and produces subtle symptoms that can be confused for other conditions. Most of the symptoms of hypothyroidism also apply to Hashimoto’s: fatigue, intolerance to cold, depression, weight gain, and dry skin and hair. Irregular menstruation also may clue in your physician to test for Hashimoto’s with a blood screen. Treatment may rely on hormone-replacing medications or, in rare cases, removing part of the thyroid.

Hyperthyroidism, or overactive thyroid

Less common than hypothyroidism, overactive thyroid disorder usually is caused by Graves’ disease (see below) and, unsurprisingly, causes the reverse of many of the symptoms of hypothyroidism, like a racing heart, restlessness, weight loss, and trouble sleeping. You might also notice that your hair and nails have become brittle. 

Treatment for hyperthyroidism may mean drugs that slow down hormone production, large doses of radioactive iodine to inhibit the thyroid’s activity, or surgery to remove the thyroid gland. Your medical provider may use a blood test to determine whether your thyroid is overactive and a radioiodine uptake test or ultrasound to determine treatment. 

Graves’ disease

Like Hashimoto’s disease, Graves’ is an autoimmune disorder in which the thyroid is mistakenly attacked by the immune system, but in Graves’, the attack increases hormone production. 

Graves’ disease is hereditary and usually appears in women in their 20s. Its symptoms mimic those of hyperthyroidism but also include enlarged thyroid and bulging eyes. There’s no treatment for Graves’ disease, and so your physician may use beta-blockers to control the symptoms, as well as antithyroid medications to slow down hormone production. Removing part of your thyroid through surgery or destroying part of it through radioactive iodine may be necessary in extreme cases. 


Your thyroid requires iodine to function properly. An iodine deficiency can lead to goiter, or enlarged thyroid. In the United States, iodine deficiencies are rare, so goiter is more likely a symptom of hyperthyroidism, wherein your thyroid is too active for a standard diet to keep up with its iodine needs. 

Goiter may produce no symptoms at all, or if it becomes large, may make breathing or swallowing difficult and cause your neck to feel swollen. A physical exam and blood test diagnose goiter, and it’s usually treated with iodine—or with standard hyperthyroid treatments if it results from that condition. 

Put your mind at ease with a simple blood test

If you have any reason to suspect that your thyroid is doing more or less than it should, a blood test will provide the answer you need. For each of the thyroid conditions detailed here, your doctor can take a look at thyroid hormone levels to determine whether any treatment or additional testing is necessary. Don’t let symptoms weigh on your mind.

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