March 24, 2021
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Your thyroid gland keeps your body’s metabolism humming and plays a key role in your overall well-being. So if you have some type of thyroid disease, you’d know it, right?
Not necessarily, says endocrinologist Mary Vouyiouklis Kellis, MD. In fact, here are several problems with the butterfly-shaped gland at the base of the neck:
Thyroid problems are very common. Some experts say that if you’re a woman over the age of 35, then your odds of developing a thyroid disorder are more than 30%. Lots of things can trigger thyroid problems, including genetics, an autoimmune attack, pregnancy, stress, nutritional deficiencies, or toxins in the environment, but experts aren’t entirely sure.
Diagnosing thyroid problems is very challenging; symptoms are often vague and nonspecific, such as fatigue, depression, and anxiety. Perhaps that’s why the butterfly-shaped endocrine gland remains one of the most misunderstood parts of the body.
Here, thyroid experts separate fact from fiction.
Myth #1: If you have a thyroid problem, you’ll definitely know it because the its symptoms are obvious.
The symptoms of thyroid disease can be subtle and easy to overlook. Because of symptom subtlety or overlap, thyroid disease can be tricky to diagnose, Dr. Kellis says.
“Thyroid-related symptoms can be present in many different medical conditions,” says Dorothy Fink, MD, endocrinologist and assistant professor of medicine at NYU Langone Medical Center in New York City. Common symptoms include extreme fatigue (even after a full night’s rest), brain fog, anxiety, heart palpitations, dry skin, and high blood pressure.
Dr. Fink says thyroid disorders are often misdiagnosed in women in particular because other female-specific, hormone-related conditions can have similar symptoms, including premenstrual dysphoric disorder, perimenopause, or menopause. Simply being overweight can create symptoms that mirror those of thyroid diseases as well, Dr. Fink notes.
A test for thyroid stimulating hormone (TSH) can identify thyroid problems before symptoms occur. But if you don’t report symptoms, your doctor may not screen you for thyroid disease.
Ask your doctor about screening if your family has a history of thyroid disease. Heredity is a factor in Graves’ disease, Hashimoto’s disease (a type of hypothyroidism) and thyroid cancer.
Myth #2: If you have a lump on your neck, you definitely have a thyroid problem.
A lump on the neck is not necessarily a goiter (enlarged thyroid). “While the thyroid is the most common thing that can enlarge in your neck, there are a lot of other things in the neck besides the thyroid,” says Dr. Fink.
Other causes of a neck lump could be a swollen lymph node or cyst. Either way, Dr. Fink recommends you get any neck lumps checked out by your doctor, who will evaluate the problem (or lack thereof) with a quick exam and order up ultrasounds or CT scans, if necessary.
Myth #3: If you’re tired and gaining weight, there’s definitely something wrong with your thyroid.
“The symptoms of an underactive thyroid are very non-specific, meaning they can present with many different conditions,” says Dr. Fink. “I always tell patients I’m looking at them as a whole person, not as just their thyroid gland, even though they may come to me saying they have a thyroid problem.”
For female patients, Dr. Fink first looks at the menstrual cycle, which often causes symptoms similar to those found in thyroid disease patients. “Symptoms like fatigue and weight gain can come up with a thyroid condition or with a menstrual cycle,” says Dr. Fink. “One good trick is to find a good app to track your period and that can help us sometimes understand your body better and the daily fluctuation of hormones.” If your period isn’t to blame for tiredness or a few extra pounds, Dr. Fink says a TSH test is the next step in diagnosing a true thyroid condition.
Myth #4: If you have thyroid disease, your eyes will bulge.
Graves’ disease, the most common form of hyperthyroidism, sometimes – but not always – causes bulging eyes. (Note that smoking increases your risk of developing this problem.)
Other eye problems linked to Graves’ disease include double vision, dry eyes and swollen eyelids.
But just 10 to 20% of Graves’ disease patients develop significant eye disease, notes Dr. Kellis.
“We tell smokers with Graves’ disease to stop smoking,” she says. “We can treat eye disease with selenium supplements and steroids. And for severe bulging, we can do surgery.”
Myth #5: If you have a thyroid nodule, then you must have cancer.
“Thyroid nodules are most often benign, and half the women over age 40 have them,” Dr. Kellis says.
So if a nodule develops on your thyroid gland, don’t hit the panic button. Doctors find cancer in fewer than 5% of thyroid nodules.
If the nodule is a solid 1 centimeter or larger, your doctor likely will take a sample of cells (biopsy) to see if it is cancerous.
“Many patients ask whether a blood test can determine if a nodule is cancerous,” she says. “However, the initial diagnosis of thyroid cancer is made by thyroid biopsy, not by a blood test.”
Myth #6: Only older woman can develop thyroid problems.
Thyroid disease can affect men and women at any age. However, women do have a higher chance of developing a thyroid problem, says Dr. Fink.
“I have tons of young women with thyroid conditions,” she says. “Your genetics plus environmental factors are usually what tip someone over into developing an autoimmune-related underactive or overactive thyroid condition. It can present across any age, but it has a predilection for women.”
Christian Nasr, MD, an endocrinologist at the Cleveland Clinic, says women are more likely to develop thyroid conditions because they have higher estrogen levels than men. “Estrogen makes the cells more visible to the immune system, so women tend to be more affected by all thyroid conditions – hypothyroidism, hyperthyroidism, nodules, and thyroid cancer,” Dr. Nasr says.
Myth #7: Consuming extra iodine will improve your thyroid health.
You may hear that it’s important to take iodine supplements when you have thyroid disease. Advertisers make this claim because iodine deficiency is the leading cause of thyroid disease around the world.
Your thyroid needs iodine to function properly, but taking supplements or eating a ton of seaweed could actually do your thyroid more harm than good, Dr. Fink says. Excess iodine can trigger thyroid dysfunction: “If you don’t have the proper mechanisms working in your thyroid to shut it down when it’s overdosed on iodine, it will turn into this iodine-using factory and keep churning through all this iodine and make too much thyroid hormone,” she says. “It can cause an overactive thyroid if you really overdose on it.”
Myth #8: Doing headstands will alleviate your thyroid disease symptoms.
There’s a myth that doing headstands or other inverted yoga poses alleviates thyroid disease symptoms by increasing blood flow to the gland. And sure, yoga can strengthen the body and soothe mind, but the truth is, no number of downward dogs will cure your thyroid condition or prevent one from occurring. Still, Dr. Fink and Dr. Nasr say if inversions make you feel healthy, go for it. Plus, daily yoga could help your symptoms in other ways. “I would assume someone who is doing yoga is less stressed,” says Dr. Fink, “and losing weight would benefit because if you weigh less, you can take less thyroid hormone.”
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