The thyroid is a small, butterfly-shaped endocrine gland located at the front of the neck, above the collarbone. An endocrine gland is a gland that produces hormones that regulate different body systems and functions. The thyroid hormones (T3 and T4) regulate multiple body functions including your:
- Heart rate
- Cholesterol levels
- Calcium levels
- Menstrual cycles
Like all your body’s systems, the thyroid gland and the hormones it produces are carefully regulated. Your thyroid is controlled by the pituitary gland and the hypothalamus in your brain. When there are not enough thyroid hormones in your body, the hypothalamus releases the hormone TRH. TRH tells the pituitary gland to produce the hormone TSH. TSH then triggers your thyroid to make more thyroid hormones until your body reaches hormonal balance.
Sometimes, this careful system of hormone regulation doesn’t work properly, and the cause is likely a thyroid condition. There are multiple thyroid conditions including Hypothyroidism, Hashimoto’s Disease, Hyperthyroidism, Graves’ Disease, Thyroiditis, and Thyroid Cancer.
Hypothyroidism and Hashimoto’s Disease
“Hypo” means under or below. If diagnosed with hypothyroidism, you have an under-active thyroid gland that does not produce enough thyroid hormones. Hypothyroidism causes many body systems to slow down, resulting in symptoms such as:
- Slowed heartbeat
- Muscle weakness
- Sensitivity to cold
- Dry skin
- Slow thought process and poor memory
- Weight gain
- Increased thyroid size
5/100 people have hypothyroidism. It can be caused by thyroid removal, radiation for another condition, being born without or a partially formed thyroid, and taking some medications. The most common cause of hypothyroidism is Hashimoto’s Disease.
Hashimoto’s Disease (or Hashimoto’s Thyroiditis) is an autoimmune disorder, meaning that the body is attacking itself. In this condition, antibodies abnormally attack and damage the thyroid, leaving it unable to produce enough thyroid hormones. The symptoms of Hashimoto’s can take years to appear and can include all symptoms of hypothyroidism. Hashimoto’s is often genetic and occurs more commonly in women, but can also be caused by hepatitis C, various medications, and exposure to nuclear radiation.
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Hyperthyroidism and Graves’ Disease
Hyperthyroidism is the exact opposite of hypothyroidism. Hyper – means over or in excess. If diagnosed with hyperthyroidism, you have an overactive thyroid gland that produces too many hormones. In hyperthyroidism, many body systems speed up, resulting in symptoms such as:
- Rapid heart rate
- Excessive sweating
- Hand tremors
- Difficulty sleeping
- Nervousness and anxiety
- Weight loss despite increased appetite
- Increased thyroid size
1/100 people have hyperthyroidism. Causes can include Plummer’s Disease (enlargement of the thyroid), Thyroiditis (inflammation of the thyroid), or Graves’ Disease, which is responsible for 90% of hyperthyroid cases.
Graves’ Disease is an autoimmune disorder where antibodies abnormally attach to the thyroid gland, causing it to produce more thyroid hormones than normal. It is unknown what exactly causes Graves’ Disease, but it may be genetic. The symptoms of Graves’ Disease can include all symptoms of hyperthyroidism as well as Graves’ Eye Disease (eyes that are red and bulging, swollen eyelids and double or reduced vision) and/or Graves’ Dermopathy (red, thickened skin on shins and tops of feet).
To diagnose hyperthyroidism, a blood test is completed to assess the thyroid hormone levels in your blood. If your doctor suspects that your hyperthyroidism is caused by Graves’ Disease, they will also test for antibodies in your blood and may ask you to complete a thyroid ultrasound, or a radioactive iodine test (radioactive iodine is ingested, and the thyroid is scanned to see how much iodine it absorbed). If diagnosed, doctors will prescribe anti-thyroid medication to block thyroid hormone production and often beta blockers to treat symptoms. In some cases, thyroid cells are destroyed using radioactive iodine or the thyroid is surgically removed.
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Postpartum Thyroiditis is when the thyroid becomes inflamed after delivering a baby. 5-10/100 women will experience this condition and it is more common in women with a history of thyroid disease. Women diagnosed with Postpartum Thyroiditis experience two stages: hyperthyroidism 1-4 months after giving birth and then hypothyroidism 4-8 months after giving birth. The symptoms typically subside within 12-18 months, and few women remain hypothyroid for life. For treatment, women may be given anti-thyroid medication to block thyroid hormone production in the hyperthyroid stage, and then thyroid hormone medication when they enter the hypothyroid stage.
According to CDC, 12,000 men and 35,000 women are diagnosed with thyroid cancer each year. Thankfully, the majority of cases are always curable. Thyroid cancer is often genetic and can also be caused by head and neck exposure to radiation. It does not usually cause any symptoms but can lead to neck pain in severe cases. Most people don’t even know they have thyroid cancer until a lump (or nodule) on their neck is found during a routine exam. Doctors will suggest an ultrasound and a biopsy to determine if the lump is cancerous. For treatment, the thyroid is partially, or fully removed in surgery along with the lymph glands in some cases. Occasionally, radioactive iodine may also be used post-operation to destroy thyroid cells. After surgery, patients are prescribed thyroid hormone medication for life as the body is no longer able to produce any, or enough thyroid hormones.
How do I Keep my Thyroid Healthy?
One of the best ways to take care of your thyroid is to take care of your overall health through eating well, exercising, and managing your stress. Consult your physician if you notice any enlargements or bumps at the base of your neck, or if you are experiencing any unusual symptoms. If you are female, older than 60, have a family history of thyroid conditions, and/or have an autoimmune disease such as type one diabetes, ensure your family doctor checks your thyroid regularly.
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