Thyroid Disease—Know the Facts

As we go through life, we often hear about various medical conditions—such as heart disease, high cholesterol, or osteoporosis—and the steps we can take to prevent those maladies. We don’t often hear about thyroid issues, but they are more common than you might think.

The thyroid is a butterfly-shaped gland located at the base of the neck. It’s part of the endocrine system, a system of glands that produce, store, and release hormones into the bloodstream so they can reach the body’s cells.

The main hormone is thyroxine, or T4, but there’s also T3, or triiodothyronine. The thyroid takes iodine found in the foods we eat and converts it to these two hormones. They act throughout the body, influencing metabolism, growth and development, and body temperature.

Olusola Osundeko, M.D., medical director of Holy Spirit Endocrinology – a Geisinger Affiliate, explains that the chance of experiencing a thyroid issue, such as overactive (hyperthyroidism) or underactive (hypothyroidism) thyroid, increases as we age.

Olusola Osundeko, M.D., medical director of Holy Spirit Endocrinology – A Geisinger affiliate.

“But it can occur at any age. No matter what age you’re looking at, it’s three times more common in women. People mistakenly think that it has something to do with the amount of reproductive hormones post-menopause, but it has to do with the thyroid hormones,” he stresses. “We’re not sure if there’s any specific trigger, but thyroid issues can run in families.”

He explains that underactive thyroid is more common than overactive—about 5 percent of the population is diagnosed with underactive thyroid, while 1.5 percent has overactive thyroid. The symptoms for both conditions differ.

Osundeko points out that with an underactive thyroid, the body seems to slow down: tiredness, weight gain or difficulty losing weight, and a slower heart rate.

With an overactive thyroid, people may experience heart palpitations, difficulty sleeping, and muscle weakness or have bulging eyes.

“None of the symptoms is unique to a thyroid condition. The challenge we face is that online websites may have misleading information about symptoms and thyroid issues. It is really important for people to take the issue seriously and see their doctor and get tested,” Osundeko says.

Once a diagnosis is ascertained, there are treatments for both conditions. He says that an underactive thyroid can be treated by medication, and guidelines have been developed for dosage levels.

However, medications may need to be adjusted. Osundeko explains that it takes 10 to 14 days for the medicine to kick in and six to 10 weeks for lab work to show changes. The overall results timeframe is generally within three months. However, medication needs to be taken on an ongoing basis.

Additionally, some people experience a condition known as Hashimoto’s disease, in which the immune system attacks the thyroid.

According to the Mayo Clinic, the thyroid becomes inflamed, which causes hypothyroidism, or underactive thyroid. The disease progresses slowly and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in the blood. The signs and symptoms are mainly those of an underactive thyroid gland.

“With an overactive thyroid, it’s more difficult to manage the medication. Not only does the body make proteins that stimulate thyroid function, but some over-the-counter medicines contain iodine, and they can stimulate the thyroid,” Osundeko stresses.

Treatment for overactive thyroid involves medication. Generally, individuals are on the medication for 18 to 24 months. Osundeko explains that in that timeframe, about a third of patients go into remission and don’t need the medication any longer.

“Treatment for overactive thyroid is a balancing act. It requires close monitoring so the thyroid doesn’t become underactive,” he says.

Those who don’t go into remission usually are treated with radioactive iodine to kill the thyroid. In rare cases, the thyroid is surgically removed, and he says that’s the course of treatment for patients who cannot tolerate the radioactive iodine or for pregnant women.

Osundeko says that thyroid cancer is not as common as either under- or overactive thyroid issues, and there’s generally a good success rate, especially if it has not spread to other parts of the body. Specific treatment plans depend on the type and stage of cancer and could include thyroid hormone therapy, radioactive iodine treatment, surgery, chemotherapy, targeted drug therapy, and surgery.