Symptoms of thyroid disease can often be overlooked without proper testing
The thyroid –– a small, butterfly-shaped gland in the neck that helps keep the body in balance –– is an important part of the body that produces hormones that regulate metabolism, heart rate, body temperature, and energy levels.
When the thyroid is not functioning correctly, it can lead to various symptoms, including fatigue, weight changes, anxiety, heart palpitations, and temperature sensitivity. If a thyroid disorder is left untreated, it can lead to significant issues, including bone density loss, heart arrhythmias, and even heart failure.
According to the American Thyroid Association, an estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of those with thyroid disease are unaware of their condition, and women are five to eight times more likely than men to have thyroid problems.
While the causes of thyroid problems are largely unknown, Kevin Codorniz, MD, an endocrinologist at Loma Linda University Health, says “thyroid disorders can appear at almost any stage of life, from adolescence through older adulthood.”
There is a significant amount of misinformation available online and in popular books that can mislead patients, but Codorniz emphasizes that a proper diagnosis and treatment should be conducted with a physician.
What is thyroid disease?
Thyroid hormone disorders fall into two categories: an underactive thyroid called hypothyroidism and an overactive thyroid called hyperthyroidism. These conditions affect how much thyroid hormone the gland produces, which plays a critical role in regulating the body’s metabolism.
“One way to understand the thyroid hormone is to think of it as fuel for a car,” Codorniz says. “In hyperthyroidism, it’s as if rocket fuel has been poured into the gas tank, which makes the body run too fast, the ‘engine’ will overheat, and systems like the heart begin to race. Hypothyroidism is like putting sugar in the gas tank: the body sputters, slows down, and struggles to function efficiently.”
Within these categories are specific diseases, including Hashimoto’s thyroiditis and Graves’ disease.
Hashimoto’s thyroiditis is the most common cause of hypothyroidism, in which the immune system attacks the thyroid. Graves’ disease is a disorder that causes the thyroid to become stuck in the “on” position, producing excess hormones.
Diagnosing thyroid disorder
Thyroid hormone disorders are often misunderstood, and symptoms can be misleading or overlap with many other conditions.
Common symptoms of hypothyroidism include:
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Fatigue
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Brain fog
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Feeling cold
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Weight gain
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Dry skin
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Hair loss
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Depression
Common symptoms of hyperthyroidism include:
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Racing heart
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Jitteriness
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Heat intolerance
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Excessive sweating
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Oily skin
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Bulging eyes
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Sleep problems
It’s a common myth that a thyroid disorder can be diagnosed simply by touching the thyroid.
“While a physical exam is an important part of the evaluation, it cannot determine how well the thyroid is functioning hormonally. A thyroid gland may feel enlarged or smaller than normal, but size alone does not indicate whether someone has an overactive or underactive thyroid,” Codorniz explains.
Although certain visible signs can suggest a thyroid hormone disorder, the primary screening test for thyroid function is a blood test called thyroid-stimulating hormone (TSH). If TSH levels are abnormal, further testing may be done to confirm a diagnosis.
Treating thyroid disease
Medical intervention can restore hormone balance, protect vital organs, and improve day-to-day functioning. There is no agreed-upon lifestyle regimen that can correct low or high thyroid hormone levels, particularly when the underlying cause is autoimmune, which is the case for many thyroid conditions.
“Thyroid hormone replacement for hypothyroidism and appropriate medical treatment for hyperthyroidism remain essential. Without these treatments, patients can become seriously ill,” Codorniz says.
When a thyroid disorder goes untreated, the effects on the body can be serious and wide-ranging and can significantly affect quality of life. Whether thyroid hormone levels are too high or too low, lack of treatment allows these effects to worsen over time.
While lifestyle changes should not replace medication, Codorniz says maintaining good overall health may help the body better cope with an autoimmune condition.
“Eating a balanced, nutritious diet, staying physically active, managing stress, and prioritizing sleep all contribute to general well-being,” he says.
Busting thyroid myths
Codorniz warns against using alternative or “natural” therapies in place of medication, as they are not evidence-based.
“To date, no alternative therapies have been shown to effectively replace standard medical treatments for either low or high thyroid function. The most effective approach remains evidence-based medical management, with lifestyle habits serving as a complementary, not primary, strategy in managing thyroid disease,” Codorniz says.
If you’re experiencing persistent symptoms like unexplained fatigue, weight changes, heart palpitations, or feeling unusually cold, don’t dismiss them as normal. Talk to your primary care provider about whether thyroid testing is appropriate for you.
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