Sometimes the thyroid does too much, or too little

Disorders of the thyroid gland are among the most common hormonal disorders which cause disease.

The thyroid is a gland located in the front of the neck made up of soft tissue which produces thyroid hormone that is released into the bloodstream. The gland is under the control of the pituitary, which is another gland in the substance of the brain.

Thyroid hormone regulates metabolism and the functioning of many of the body’s tissues. Common thyroid disorders include conditions in which the thyroid is overactive (known as hyperthyroidism) and conditions in which the thyroid is underactive (known as hypothyroidism).

Thyroid function problems often result from the effects of antibodies produced by the immune system, which may either stimulate the thyroid or damage the gland so that it no longer produces thyroid hormone. In either circumstance, the thyroid gland may occasionally become enlarged, producing a so-called goiter which may be visible at the front of the neck.

An overactive thyroid gland produces symptoms of a revved-up metabolism. Common symptoms include palpitations or fast heart rate, anxiousness, irritability or tremor, intolerance to heat and sleeplessness. Women may experience a decrease or absence of menstruation. In people with an overactive thyroid, increased appetite may be paradoxically associated with weight loss.

A severely overactive thyroid condition that remains undiagnosed and untreated can lead to a potentially life-threatening condition known as thyroid storm. This condition is often marked by fever, excessive sweating, severe anxiety or even psychosis as well as nausea, vomiting and diarrhea.

On the other end of the spectrum is hypothyroidism, resulting from an underactive thyroid. Symptoms result from a slowed metabolism. People with hypothyroidism often experience fatigue and weakness. This may be accompanied by weight gain, constipation and intolerance to cold. Hoarseness may develop along with poor memory and slowed thought process.

A severely underactive thyroid that remains untreated can lead to a life-threatening condition known as myxedema coma. This is characterized by low body temperature, slow heart rate with low blood pressure, and severe tiredness or coma.

Diseases of thyroid function are easily diagnosed with blood tests. Treatment of an underactive thyroid is usually successful with thyroid-hormone replacement in the form of a daily pill. When the condition results from antibody damage to the thyroid gland, treatment is typically life-long.

Initial treatment of overactive thyroid generally consists of taking a pill to block thyroid hormone production. This may induce a remission of the condition during a period of months, which may permit discontinuation of medication.

Occasionally when an overactive thyroid condition persists, treatment with radioactive iodine may be needed to permanently suppress the overproduction of thyroid hormone.

Treatment of common thyroid function disorders requires lab testing and prescription medication from your medical provider.

Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.