Meet Your Thyroid Part 2

Do You Have a Troubled Thyroid? Learn the Clues!

Hello there dear readers. Thank you for coming back for Part 2 of this series about your thyroid. Part 2 features clues that may indicate that you're thyroid has a problem. Just in case you missed part 1, you may want to read it first. If you want to learn some important ways for how to support your troubled or not so troubled thyroid, click on Part 3.
Part 1 – Your Thyroid's Responsibilities (Its Job Description) (Click here)
Part 2 – How Do You Know If Your Thyroid Has a Problem with its Job?
Part 3 – How to Help Your Thyroid (Soon!)
How do you know if you have a thyroid problem? Thyroid diseases can either decrease or increase the activity of your thyroid. Some can also produce enlargement of the whole gland. Here are some critical clues (signs and symptoms) that may indicate you have a troubled thyroid.

CLUES THAT TELL YOU, YOU MIGHT HAVE AN OVEREXCITED THYROID (HYPERTHYROIDISM)

The individual clues are clumped together under one heading (i.e. hyperthyroidism). This makes the discussion of these clues easier to comprehend and to remember.

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If you're thyroid gland gets too excited or exhibits too much activity, the condition is called hyperthyroidism. In this case there is an excess of thyroid hormones produced. Grave's disease is the most common cause of hyperthyroidism. It's a type of autoimmune disorder wherein your own immune system mounts an attack on your thyroid. Out of confusion, your thyroid gland gets stimulated and reacts by producing more hormones.

Another possible cause of this excited state (hyperthyroidism) is a thyroid nodule. In its most basic form, a nodule is simply a lump on your thyroid. This lump can grow from a normal thyroid and produce excess hormones. There are other causes of hyperthyroidism, but Grave's disease and a hyperfunctioning thyroid nodule are among the most common causes.

So how do you know if you have an overexcited thyroid? The clues reflect increased activity of the sympathetic nervous system. The sympathetic nervous system is that part of your nervous system responsible for your reaction to stressful conditions (whether you will stand up and fight, or flee the situation). In addition, an overexcited thyroid can also lead to a hypermetabolic state. This means that your metabolism increases when you have lots of circulating thyroid hormones in your system. Check out the clues below:

1. Heat intolerance – How are you handling the heat? Are you having a difficult time adapting to a warm environment? Excess thyroid hormones disrupt your body's ability to regulate its temperature by increasing the activity of your sympathetic nervous system. Your sympathetic nervous system essentially becomes over-excited by the increased levels of thyroid hormones circulating in the body. For all you techies out there, your sympathetic nervous system behaves like an Intel Xeon processor (a really powerful processor) without a fan or cooling system when all your body can really handle is an Intel Celeron processor (old school processor). For the car lovers, your body (the car) easily overheats and blows off steam by sweating during hot weather. Your thyroid gland and sympathetic nervous system both increase your metabolism which subsequently raises your body temperature.
2. Weight Loss – Have you lost a lot of weight even if you consume the same amount of food and have the same appetite? Or, are you eating more often and ingesting bigger servings of food, but still not gaining weight? Your basal metabolic rate increases because of the excessive amounts of thyroid hormones. The thyroid hormones help you burn your food.

3. Palpitations, tachycardia, arrhythmia – Do you constantly feel the pounding (palpitations) of your heart? How fast is your pulse? The normal pulse rate at rest is between 60 to 100 beats per minute. If your pulse rate is consistently above the normal even when you're not exerting any effort (called tachycardia), you may have an overexcited thyroid. The excessive levels of thyroid hormones can determine how fast and how hard the contraction of your heart will be. Eventually, your heart will get tired and have an unusual rhythm (arrhythmia).

Thanks to the overactivity of your sympathetic nervous system because of the excess thyroid hormone levels, you may also experience the following clues:

4. Anxiety – Do you feel anxious, nervous or distress most of the time?

5. Irritability – Do you get irritated or annoyed easily?

6. Bowel Movements – How is your bowel movement? Has it increased in frequency? Diarrhea? The diarrhea is due to decreased transit time along your gastrointestinal tract. Everything you ingest moves in a hurry through your digestive system. The food, water and nutrients aren't efficiently absorbed because they're not given ample time to be digested. This is because your intestines increase their movements when exposed to excessive amounts of thyroid hormones.

7. Sleeping – Do you have a hard time sleeping? Excess thyroid hormones can keep you awake. The thyroid hormones make the receptors for epinephrine, dopamine and norepinephrine (catecholamines) in your brain extra sensitive. As a result, your brain stays active longer, meaning less sleep for you.

8. Distal Extremities (hands and feet) – Do you experience trembling or shaking in your hands and feet? This is not like Muhammad Ali's tremors (he has Parkinson's disease). The tremor being referred to here happens at 10 to 15 times per second (they are called fine tremors).

Your other body systems can also be affected like:

9. For the ladies only – Are you having irregular, less frequent periods? How about the amount of menstrual flow? Do you have a lighter menstrual flow?, Are they less frequent than your usual (oligomenorrhea)? Some women even report skipping their menses (amenorrhea).

10. Osteoporosis (a condition where you have bones that easily break because of their weak framework) may be a subtle clue that you might have hyperthyroidism. It can appear way ahead of the above symptoms. Postmenopausal ladies are especially vulnerable to osteoporosis. Excess thyroid hormones initiate bone resorption (breakdown of bone) by activating osteoclasts (bone cells which break down bone).

11. Eye Changes – staring, wide gaze and lid lag are present because of hyperactivity of the sympathetic nervous system. True thyroid eye disease associated with proptosis (also called exophthalmos) is seen in Graves disease. Eye proptosis happens when the eyeballs (Yes, the eyeballs!) become displaced forward and are unable to return properly into their sockets. This may gross you out, but eye-popping (layman's term for proptosis) is included in the Guinness Book of Records. These record holders do it on purpose, unlike those afflicted with thyroid eye disease.

CLUES THAT TELL YOU, YOU MIGHT HAVE A LESS EXCITED OR UNDERACTIVE THYROID (HYPOTHYROIDISM)

On the other side of the spectrum is hypothyroidism. This is the condition wherein your thyroid gland doesn't produce sufficient amounts of thyroid hormones to support bodily functions. What is worrisome about hypothyroidism is that about 4% of the general population aren’t aware that they have it (also called subclinical hypothyroidism). Only about 0.3% of the general population show the clinical clues and it's a lot more common among women than in men (10:1).

On a global scale, endemic iodine deficiency is one of the major causes of hypothyroidism. This is common in developing nations and in other regions of the world where sufficient iodine intake is lacking. Hashimoto's disease, an autoimmune disease, is the most common cause of hypothyroidism in the US. If you have Hashimoto's disease, your immune system attacks your thyroid, rendering it useless or hypo functioning. Other significant causes of hypothyroidism include patients whose thyroid glands have been removed for surgery (post thyroidectomy patients), therapy for hyperthyroidism, and patients who receive radiation therapy for cancers found in the head and neck region.

In contrast to clues found in people with an overexcited thyroid, those with an underactive thyroid develop clues over a span of several years. More often than not, the presenting clues include easy fatigability (you tire easily) and weakness (lack of energy). Your metabolism will slow down, and you will subsequently gain weight. Hypothyroidism among adults and older children is called myxedema. The condition is called myxedema because their physical appearance is made up of additional substances (proteins and carbohydrates with really weird sounding names) which are deposited in different parts of their body making them look puffy or overweight (edematous). If the changes of hypothyroidism occur during infancy and early childhood, it is called cretinism. Other clues of a less active thyroid include:

1. Depression – People with hypothyroidism may be perceived as being depressed most of the time. This is because their lack of energy, sluggish mental acuity, and apathy can be viewed and interpreted as being depressed.

2. Constipation – How is your bowel movement? Having difficulty passing well formed stools? Are you spending too much time on the toilet? The constipation is mainly attributed to the decreased blood levels of thyroid hormones. The thyroid hormones are partly responsible for the increased motor activity (motility) of your gastrointestinal tract. Decreased motor activity will either come out as very hard stools, a decrease in the caliber of your stools (goat-like!) or less than three bowel movements a week. All of these can be perceived as constipation. Do any of these sound familiar?

3. Muscle weakness accompanied by muscle and joint pains – The muscle weakness is due to decreased cardiac output. Your muscles don't get enough oxygen and nutrients to function properly. Conversely, decreased venous blood drainage slows down the elimination of toxic wastes and byproducts from your muscles. More often than not, patients have difficulty exercising and experience breathlessness.

4. Inability to tolerate cold temperature – Do you have a hard time coping with cold weather? Does it seems as if your body can't generate enough heat on its own to adapt to a colder environment? You may have a hard time generating body heat and producing sweat, making you vulnerable and sensitive to colder temperatures.

5. For the ladies – more frequent periods (polymenorrhea) which may last longer, irregularities, excessive bleeding (menorrhagia) and heavy cramping.

6. A puffy (broadening and coarse) face, hoarse voice and pale, dry skin complete the physical features of hypothyroidism. This type of physical appearance can be attributed to the accumulation of substances (called glycosaminoglycans and hyaluronic acid) in the body locations enumerated. The pale dry skin is secondary to decreased blood flow.

Note: A hoarse voice may also signal something more serious. This climbs two steps up the ladder if accompanied by significant weight loss (unintentional) and an immovable hard mass in the neck region. Let's hope not (the big C). Of course, you do understand that you will have to consider the chances that in the absence of the latter two clues, you just might have strained your voice by shouting at last nights Jonas Brothers concert. Shhh.

CLUES THAT TELL YOU, YOU MIGHT HAVE A VERY LARGE THYROID (GOITER)

Simply put, a big (or very large) thyroid gland is termed goiter. The enlarged thyroid could be normally functioning or not. The most common cause of an enlarged thyroid gland on a global scale is iodine deficiency. Decreased levels of thyroid hormones will tell your pituitary gland to produce more thyroid STIMULATING hormone (TSH). Thyroid STIMULATING hormone (TSH) will STIMULATE (activate) the thyroid follicles (the glands within your thyroid) to become bigger to produce more hormones. In other words, it becomes big to suck more iodine from your system so it can make more hormones. Eventually, if the iodine deficiency is severe enough, the result will be an underactive thyroid (hypothyroidism). You end up with a big, less active thyroid. 177858392

When we say diffuse enlargement, we mean that there are no obvious nodules (big bumps on the surface) when you look at it from all sides. Goiter is NOT DIRECTLY synonymous with a mass in the thyroid. A thyroid mass could signify a malignancy (cancer). So please, have your thyroid carefully assessed by your doctor. Don't scare yourself! Consult the proper authorities to be sure. Additional tests and examinations are usually required. The main problem with a goiter is its size, as a big thyroid gland can put pressure on surrounding structures in your neck such as your esophagus and windpipe (trachea).

So what are your clues then? Besides the VERY OBVIOUS enlargement of your thyroid gland, you can experience difficulty with breathing, difficulty swallowing food and neck strain. All of these are due to the compressive effect of the enlarged thyroid especially when you're lying down.

CLUES THAT TELL YOU, YOU MIGHT HAVE THYROID CANCER

Cancer will always be on the back of everybody's mind. You may have thyroid cancer on top of a goiter and not know it. When thyroid cancer is starting out, you may not notice any clues. As it enlarges, it may cause some of the following symptoms:

1. Enlarged lymph nodes around your neck.
2. You may have difficulty in swallowing (dysphagia).
3. Voice changes especially hoarseness (husky voice).
4. A mass or lump, which can be palpated (felt through manual examination of the neck area).
5. Throat pain.

If you're experiencing any of these, have your thyroid checked out by your doctor.

Summary

The clues described above are physical symptoms which may be detected by any concerned citizen of thyroid health. You don't have to be a doctor to notice them. There are other thyroid symptoms not listed here. As you have probably noticed, grouping your symptoms under these categories (hyperthyroidism, hypothyroidism, goiter, thyroid cancer symptoms) can make it easier for you to pinpoint the cause of the thyroid problem. We're not here to tell you to diagnose yourself. Talk to your doctor about your symptoms to get a diagnosis. Of course, the relevant point I'm trying to elucidate here is that by being familiar with these clues, you will have an idea whether or not the problems you're experiencing may be coming from your thyroid. That alone is a feat! Knowing and understanding thyroid symptoms can help you make better health decisions. In addition, we want you to know that you can explain your symptoms better if you know the underlying troubled organ. Your thyroid gland will thank you for realizing that.

Now that you know the clues for a troubled thyroid, why don't you check out part 3 of this three part series . It deals with tips for how to support the health of your thyroid.