Recognizing and Treating Thyroid Disease

For a small gland, the thyroid has a big responsibility. It controls many bodily activities by means of two hormones, called T3 and T4. When the thyroid produces the right amounts of T3 and T4, heart rate and metabolism function optimally. When the thyroid isn't working properly, problems can develop.

This condition occurs when your thyroid does not produce enough T3 and T4, and it's most often seen in women who are at least middle-aged. It usually comes on gradually; often people don't realize they have the condition. The primary symptom may be fatigue, which someone with hypothyroidism may chalk up to job demands or aging. It's also common to gain weight without any change in diet. A doctor may suspect hypothyroidism if someone also experiences any of the following:

  • feeling colder than usual
  • constipation
  • muscle weakness or pain
  • depression
  • facial puffiness

A simple blood test will reveal the level of thyroid hormone in the body. If it's low, synthetic thyroid hormone is commonly prescribed to correct the issue.

Basically the opposite of hypothyroidism, hyperthyroidism means the thyroid is producing too much T3 and T4. A person with this condition may have one or more of the following symptoms:

  • weight loss, even while eating a lot
  • a fast and/or irregular heartbeat
  • feelings of  anxiety and irritability
  • trembling hands and feet
  • feeling hot
  • difficulty sleeping

In some people, particularly postmenopausal women, osteoporosis (fragile bones) may be one of the first symptoms. Hyperthyroidism is treated with medication that blocks the production of thyroid hormones. A physician also may administer radioiodine (radioactive iodine) to damage or destroy the hormone-making thyroid cells. Surgery to remove the thyroid may be necessary. Patients who receive radioiodine or undergo surgery must take thyroid hormone drugs for the rest of their lives to replace the missing hormone.

An inflammation or swelling of the thyroid, this can occur at various times of life. Some women experience postpartum thyroiditis, in which the thyroid may initially produce too much hormone after childbirth and then, later, not enough hormone. Silent or painless thyroiditis is similar, except the condition is not triggered by childbirth. Subacute (less severe) thyroiditis presents as swelling of the thyroid gland, with pain that radiates into the neck, jaw, or ear. This may be caused by infection.

Thyroid Cancer
This rare cancer typically manifests as a painless lump on the thyroid, although most of these are nothing more than benign (noncancerous) growths. A cancerous lump may cause visible swelling, swallowing problems, and hoarseness.

An abnormally swollen thyroid, a goiter can manifest as a large swelling in the neck that can cause breathing and swallowing problems. A goiter may be caused by lack of iodine in the diet, hypothyroidism, or hyperthyroidism. In this country, most goiters are caused by multiple nodules (small masses or lumps), and their cause is unknown. When patients develop difficulty breathing or swallowing, surgery may be recommended.

Vadim Gushchin, MD, reviewed this article.

Source:, U.S. Department of Health and Human Services Office on Women's Health. "Thyroid Disease Fact Sheet." Web. Content last updated Jan. 14, 2010.