You may never have given your thyroid gland a thought. It's tucked away at the front of your neck, about the size and shape of a bow tie. But this hard-working gland tells your body how fast to tick over by producing a hormone called thyroxine - and up to one in 50 women will get problems with it.
An underactive thyroid slows your metabolism - symptoms include tiredness; feeling the cold; putting on weight despite eating less; constipation; depression; dry skin and hair thinning. An overactive thyroid does the opposite - you may feel jumpy and anxious; dislike the heat; lose weight despite eating more; suffer from diarrhoea and get palpitations.
Feeling tired all the time is a common complaint in our over-busy world - but if you have other symptoms it's worth getting your thyroid gland checked out with a simple blood test. Both conditions usually respond very well to treatment, and you may find yourself back on top form within weeks.
Women are up to 10 times more likely than men to get thyroid problems, although nobody knows why. You're also more at risk in pregnancy; if you're over 50; if you have another condition like pernicious anaemia, type 1 diabetes or the skin condition vitiligo; or have thyroid disease in the family. Some medicines, including lithium (for mental health problems), and amiodarone (for certain heart rhythm issues) are also associated with underactive thyroid. Rather unfairly, having an overactive thyroid increases your risk of getting an underactive one later in life.
Treatment for underactive thyroid
If you're thyroid is underactive, you'll need to take levothyroxine tablets for life. It may take a little time, and a few dose changes, to get the right dose for you. During this time you'll probably need blood tests every couple of months. Fortunately, the great majority of patients do find the right dose and feel completely well as long as they take their daily tablet. And once your condition is stable, you'll only need a blood test once a year.
What if your tests are normal but you have symptoms of underactive thyroid?
Your doctor should do several tests with one blood test, including 'free thyroxine' (also called free T4), thyroid-stimulating hormone (TSH) and possibly free T3. Some people have symptoms suggestive of underactive thyroid either with completely normal thyroid function tests or a normal free thyroxine level but a slightly raised TSH level. TSH is the hormone that tells your body how much thyroxine to produce. If this is high, you can be diagnosed with 'subclinical hypothyroidism' even if your free T4 is normal. You may find that your symptoms respond to levothyroxine tablets. However, there is some evidence that treating with thyroxine when your T4 is normal might increase your risk of complications such as osteoporosis. You can find out more at patient.info's professional reference article on subclinical hypothyroidism. Do speak to your doctor about the pros and cons.
Treatment for overactive thyroid
There are several treatments available, and your doctor can help you choose the best one for you.
You can take regular tablets called carbimazole, usually for 12-18 months. You'll be followed up regularly and your dosage adjusted depending on your blood test results. Many people's thyroxine levels come down to normal after that time, and you may be able to stop them unless your symptoms return.
Taking a single dose of radioactive iodine may sound scary, but it's a safe and often effective way to treat overactive thyroid. You'll need to take precautions to avoid close contact with others for a few weeks, but your doctor can advise you.
If your condition has made your thyroid gland enlarge, surgery to remove part of it may be an option.
Sometimes you may be given beta-blocker tablets for a few weeks while your thyroxine levels are being brought back to normal by another treatment. These help with palpitations and anxiety.
If your thyroid gland later becomes underactive, you can take levothyroxine tablets just like anyone else with an underactive thyroid.
The eyes have it
Up to half of people with an overactive thyroid get eye symptoms including dryness, irritation and bulging eyes. These are usually fairly mild, and can be treated with eye drops and eye protectors at night. About one in 20 people are more severely affected. If you are, an eye specialist can help with a range of treatments including surgery and steroid tablets
Getting your thyroid in balance - the health benefits
The right treatment should relieve your symptoms long-term. Even better, getting your thyroid hormone balance right can protect you against heart disease and osteoporosis (or 'thinning' of the bones.
With thanks to 'My Weekly' magazine where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.