Photo: iStock Everyone is probably aware that they have a thyroid gland, and that it is related to metabolism, but many people don’t know how it functions in the body. January is Thyroid Awareness Month, so we spoke to Dr. Terry Davies , professor of medicine, endocrinology, diabetes and bone disease and director of the Thyroid Center at Mount Sinai Union Square, to tell us more. What you need to know about your thyroid
What is the thyroid, and how does it function in our bodies?
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The thyroid gland is a small, butterfly-shaped gland located in the base of the neck, just below the Adam’s apple. Although relatively small, the thyroid gland plays a huge role in our body. The thyroid produces hormones that regulate the body’s metabolic rate (how we process food and produce energy), as well as heart and digestive function, muscle control, brain development, mood, and bone maintenance. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism.
How many people do thyroid disorders affect?
Thyroid disease is very common. Thyroid disease is one of the most common, yet misunderstood and overlooked, conditions in Americans. By the time we reach 60 years of age, almost 60 percent of people have developed thyroid growths (nodules), although very few are cancerous growths. In addition, almost 5 percent of the population may have too much or too little thyroid hormone.
What can we do to maintain a healthy thyroid?
There is a lot of misinformation on the internet about diet and thyroid. One of the most important things you can do to maintain a healthy thyroid is eating a well-balanced diet. With a normal diet, we have very little dietary influence on thyroid function. In the world as a whole, iodine deficiency is the most common cause of a low thyroid. However, in New York, we rarely see such deficiency except perhaps in pregnancy or people on strange diets. The best way to keep the thyroid healthy is to keep the entire body healthy with a good nutritious diet and plenty of exercise. Low thyroid is often blamed for obesity or depression and high thyroid is often blamed for weight loss or anxiety. Checking blood tests for thyroid function may be a good idea in such situations.
What can disrupt the thyroid’s function?
There are some drugs that can interfere with thyroid hormone output by the gland (such as amiodarone) but the most common causes are what we call autoimmune. These are conditions where the immune system mistakenly attacks our own bodies – sometimes a particular part – such as joints in rheumatoid arthritis or the thyroid gland – and sometimes multiple systems such as in severe Lupus. When the body tries to destroy the thyroid then we become thyroid deficient (Hashimoto’s disease) and if the immune system overstimulates the thyroid gland then we produce too much thyroid hormone (Graves’ disease).
What is hyperthyroidism? What is hypothyroidism?
Hyper means too much and hypo means too little. Hyperthyroidism is an overactive thyroid gland (from Graves’ disease or overactive nodules) and hypothyroidism means too little thyroid hormone (such as Hashimoto’s disease or after a surgeon has removed the gland because of cancer).
Are there any populations that are especially affected by thyroid disorders?
Thyroid disease affects all age groups, although it is uncommon before puberty. Women, however, are seven times more likely to have thyroid disease than men. And young women are more commonly affected than older women. Most doctors are concerned with pregnant women because we need to be sure that the baby gets just the right amount of thyroid hormone. High-risk women should be screened, but simply being female boosts the risk of thyroid disease.
How are disorders/diseases tested for?
Your doctor can diagnose hyperthyroidism and hypothyroidism by testing the levels of thyroid hormones in your blood. The tests measure hormones from the thyroid itself, as well as thyroid-stimulating hormone (TSH), a chemical released by the pituitary gland in the brain that triggers your thyroid. When you have hypothyroidism, you have higher TSH levels because your body is trying to tell your thyroid to make hormones. The reverse is true with hyperthyroidism, TSH levels are below normal and thyroid hormone levels are high. For growths on the thyroid, a physical examination is insufficient. An ultrasound examination is needed to
For growths on the thyroid, a physical examination is insufficient. Nodules that appear suddenly are typically fluid-filled sacs. Go to a doctor and have them check with an ultrasound exam.
How are they treated? Can you live without a thyroid gland?
Thyroid-problem treatments vary and may include monitoring, medications, surgery or radioactive iodine. The majority of thyroid nodules don’t require treatment. Treatment options for larger or cancerous nodules, or nodules that produce additional thyroid hormones, may include medication or surgery. Graves’ disease is also sometimes associated with an eye disease, which can be a real problem.
If you don’t have a thyroid gland, you can expect to have many of the same symptoms as the more common types of hypothyroidism that occur due to an underactive thyroid gland. You may also require similar medication treatment. When the gland is overactive, then thyroid hormone tablets are needed to stop the overproduction or the gland needs to be destroyed (by radioactive iodine or surgery). So generally, if there is thyroid dysfunction it is best to see a “thyroidologist” who is an endocrinologist with a special interest in thyroid disease.
At Mount Sinai, we have a unique Thyroid Center in Union Square that allows one-stop shopping for testing, clinical evaluation, and treatment, surgical opinion, ultrasound, and biopsy all in the same place. You can call 212-420-4112 for an appointment which is guaranteed within 72 hours. Always remember to bring your test results with you whenever you visit a physician.
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