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Understanding your thyroid: This important gland regulates your metabolism

Source: Pacific Prime Health Insurance

Like all organs and systems in the human body, the hormones secreted by the thyroid gland must remain in balance to maintain good health. In simple terms, the thyroid's job is to release a measured stream of two primary hormones known as triiodothyronine (T3) and thyroxin (T4), which are responsible for controlling metabolism.

Metabolism, in essence, is the body's ability to control its core temperature, calorie-burn rate, fat storage and overall energy levels. By extension, these factors affect feelings of hot and cold, endurance and exhaustion, heart rate and weight.

What happens when the thyroid stops doing its job adequately or, conversely, starts working overtime and dumps too much hormone into the bloodstream? Here are two common conditions that warrant a visit to your doctor for further testing:


Hypothyroidism, an under-active thyroid, is the condition that results from a patient's thyroid slowing its production of T3 and/or T4 hormones. As a result, the body's natural metabolism is thrown out of balance, typically functioning slower than it should. The specific amount of metabolic slow-down is directly connected to how much the flow of T3 or T4 has been reduced.

In general, hypothyroidism is most common among females over age 60, but it can occur in anyone and at any age, including infants.

One of the most common and easily detectable symptoms associated with hypothyroidism, and a slowed metabolic rate, is sudden weight gain without any changes to diet or activity level. Additionally, hypothyroidism patients also typically complain of low energy levels and a nagging feeling of tiredness throughout the day, even with adequate sleep. Many sufferers also experience frequent constipation, erratic menstrual cycles, very dry skin, and/or depression.

Inability to maintain core body temperature, usually feeling cold when others are comfortable, is another strong indicator of a slowed thyroid. While occasional coldness is a common problem for everyone during temperature extremes, even with a fully functioning thyroid, feeling cold in only moderately cool temperature, especially in connection with sudden gained weight, is noteworthy.

Furthermore, many hypothyroid sufferers have poor circulation in their extremities -- particularly fingers and toes -- which sometimes causes them to turn blue-ish in temperatures that previously were tolerable.

For an estimated 5-10 percent of post-partum women, a thyroid flux can occur shortly after giving birth, often starting with a hyperthyroid condition which gradually settles into hypothyroidism. This is often a result of hormonal changes associated with becoming a mother, and in most cases is self-resolving in a few months to a few years. However, any woman who feels she may be at risk of, or already has, a thyroid problem during pregnancy should talk to her doctor immediately about treatment options, since irregular metabolism can have dangerous consequences for a fetus.

For patients whose hypothyroid condition has gone undetected for some time, other secondary health problems can also be indicators of low T3 or T4 levels. Hypothyroidism has been found to be an underlying cause of raised cholesterol levels, increased risk of heart attack and stroke, muscle weakening, damaged nerves, reduced fertility, and pregnancy complications.

In all of the situations mentioned above, the level of hypothyroidism may be considered to be subclinical, and mild by medical standards. In rare cases, a patient can develop clinical hypothyroidism; the total shut-down of T3 and T4 production, which in short order will result in unconsciousness, coma, and potentially death.


On the other hand, the thyroid can become over-active in its production of T3 and/or T4 hormones, a condition known as hyperthyroidism, which is frequently associated with Graves' disease.

The symptoms of hyperthyroidism are virtually the opposite of hypothyroidism, in that it causes a "revving-up" of the metabolic rate. While some have considered a few of its symptoms to actually be somewhat desirable, the reality is that it is equally life-threatening, if not more so.

One of the earliest and most recognizable symptoms of hyperthyroidism is weight loss without diet or exercise, and often with an increase in appetite. Hyperthyroidism is sometimes accompanied by the desire to fidget, mood swings without reason, irritability and/or poor, unrestful sleep.

Additionally, bowel movements may become more frequent and intense. Even in cool weather, most hyperthyroid patients complain of feeling hot since the body is constantly working to burn calories and create energy. They may sweat noticeably more, as well.

While some claim they would gladly accept feeling hot and a little bit nervous in order to feel energetic and stay thin, in reality it's not worth the risk because the most dangerous result of hyperthyroidism is a dangerously high heart-rate. Thus, hyperthyroidism greatly increases risk of heart attack, and even in less-severe cases, can cause panic attacks and frequent shortness of breath.


In the past, testing for thyroid conditions was much less precise and many patients went undiagnosed. Today however, thanks to advances in technology, targeting the specific chemical chains that indicate a shortage or overabundance of T3, T4, TSH (thyroid stimulating hormone, the chemical released by the pituitary gland that controls the thyroid's hormone production), the presence or lack of free vehicular proteins, and/or a dangerous level of anti-thyroid antibodies which prevent the thyroid from functioning properly, is much easier and more accurate.

Typically, a blood test will reveal what thyroid irregularity, if any, is occurring and then a specialist can make an assessment and recommend the best treatment for your particular condition.


The effects of a thyroid condition can be debilitating and far reaching. Thankfully, these conditions can be treated and managed through medication or, in rare cases, surgery.

Hypothyroidism is most commonly treated by prescription of the medication known generically as thyroxine. This drug will stimulate the thyroid to become more active, thus increasing metabolism. Another blood test is needed 6-8 weeks after starting treatment to ensure the dosage is correct.

Hyperthyroidism is also treatable in mild forms with medication, namely radioactive iodine, methimazole, or propylthiouracil. All of these drugs serve to inhibit the release of T3 and T4, thus slowing metabolism. In extreme cases, surgery to partially remove the thyroid, thereby reducing its function, may be recommended as a final alternative.

Additionally, since hyperthyroidism is often triggered by Graves' disease, further medication or surgery to treat its other symptoms may be required.


1. Goiters and nodules

Most nodules (lumps in the thyroid) are painless, so they usually are discovered by a doctor feeling a patient's neck during a routine physical exam. Larger nodules -- typically noticed while shaving or putting on makeup -- cause difficulty swallowing and breathing, or hoarseness. In rare cases, nodules may cause hyperthyroidism.

Most people who have a goiter aren't aware of it until the goiter becomes large enough that they can feel or see it. Goiters can grow to an enormous size before they cause symptoms such as difficulty breathing or swallowing, or a change in voice.

2. Thyroid cancer

Usually, patients don't experience any symptoms, and the cancer is found as a lump or nodule on examination of the neck or when an imaging test such as an ultrasound, CT scan or MRI is performed for an unrelated condition. In rare cases, thyroid cancer will cause pain, difficulty swallowing or hoarseness.

(WhatDoctorsKnow is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at


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