The thyroid is one of our body’s most versatile players. It maintains our metabolisms, keeps our thermostats on point, and plays a critical role in maintaining heart, brain, and digestive function. However, it’s estimated that over one million Australians are currently living with an undiagnosed thyroid disorder.
A thyroid is pretty indispensable, and I would know. Mine has been running amuck on and off for the past eight years. As a card-carrying chronic illness girlie, boasting not one but two autoimmune diseases, I’ve spent a good eight years learning about the ways our weird and wonderful bodies can go awry. One of my illnesses, Graves’ disease, sends my thyroid into overdrive, so I’m gearing up to say farewell to it for good with a full thyroidectomy.
Now, having a wonky thyroid doesn’t make me an expert in them, but I did have the distinct pleasure of chatting with two people who are, so let’s dive into the ABCs of thyroid health with the help of our trusted guides.
OK, so what is a thyroid?
According to GP and Lifestyle Medicine Physician Dr Jill Gamberg, the thyroid is a small, butterfly-shaped gland located in the front of the neck. “It sits just below the larynx (or Adam’s apple), and it plays a vital role in regulating various bodily functions,” she explains.
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What does the thyroid do?
It’s a humble little gland, but Gamberg says it’s essential in maintaining a delicate balance in the body, promoting proper growth and development, as well as the body’s overall metabolic state.
“Primarily, it produces hormones, such as thyroxine (T4) and triiodothyronine (T3), which control metabolism, influencing how the body uses energy and maintains its temperature.”
And while that already seems like a lot of work for a small organ, the impacts on the rest of the body’s systems are numerous. We’re talking about heart rate, digestion, skin maintenance, fertility, and muscle control – all affected by the essential hormones produced by the thyroid.
And just in case we needed one more reason to thank our thyroids, Gamberg adds, “It also produces calcitonin, which contributes to bone strength by helping calcium to be incorporated into bone.”
What can go wrong with the thyroid?
Multiple causes can send the thyroid off-kilter, but for simplicity, they can be split into two categories: Hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid).
Hyperthyroidism
According to Gamberg, hyperthyroidism is when the thyroid goes into overdrive, producing too much thyroid hormone and speeding up vital body functions. “Graves’ disease [one of my autoimmune diseases] is the most common cause of hyperthyroidism, but other types include toxic multinodular goitre and thyroiditis,” she explains.
Symptoms of Hyperthyroidism may include:
- Increased heart rate and blood pressure
- Palpitations
- Excessive sweating and feeling too warm
- Hand tremors (shakiness)
- Nervousness and anxiety
- Difficulty sleeping (insomnia)
- Weight loss despite increased appetite
- Increased activity level despite fatigue and weakness
- Frequent bowel movements, occasionally with diarrhoea
- Change in menstrual periods in women
Hypothyroidism
Hypothyroidism is essentially the opposite, where the thyroid gland doesn’t produce enough thyroid hormones, thus slowing down vital body functions. According to Gamberg, there can be multiple causes of hypothyroidism, but the most common is the autoimmune disease Hashimoto thyroiditis, where Hypothyroidism develops as the thyroid is gradually destroyed. “Other less common causes can be as a result of treatment for hyperthyroidism or thyroid cancer, thyroid inflammation (thyroiditis), or a chronic lack of iodine in the diet,” says Gamberg.
Symptoms of hypothyroidism may include:
- Fatigue
- Unexplained weight gain despite decreased appetite
- Constipation
- Increased sensitivity to cold
- Muscle cramps
- Facial expressions can become dull
- A hoarse voice
- Slower speech
- Eyelids droop
- Puffiness of the eyes and face
- Hair becomes sparse, coarse, and dry
- The skin becomes coarse, dry, scaly, and thick
- Changes to menstrual periods
The problem with diagnosis
Endocrinologist and Distinguished Laureate Professor Roger Smith from Hunter Medical Research Institute and University of Newcastle says that despite being easily diagnosed with a simple blood test, thyroid disorders are commonly missed – a fact that is certainly reflected by the data. According to statistics from the Australian Thyroid Association, well over one million Australians currently live with undiagnosed thyroid disorders.
When my Graves’ disease first presented, I spent a good six months being dismissed and sent home with little more than a prescription for anti-anxiety medication. Meanwhile, I was heading full speed into what’s known as a thyroid storm (sounds cool, but it’s decidedly not). When something is wrong with this little gland, the entire body is affected, including our mental health, which can make misdiagnosis of thyroid problems far too common, especially among women.
Aside from knowing the symptoms to watch for, Smith says, “It’s worth noting that thyroid disorders run in families, so you should look at this with your doctor. If you have a family member with a thyroid condition, this will increase your likelihood of having a thyroid disorder.”
Who is most at risk?
Statistically, women are ten times more likely than men to be affected by thyroid disorders. And especially when it comes to hypothyroidism, the risk increases with age.
“Hypothyroidism is common, especially among older people, particularly women,” confirms Gamberg, “it affects about 10 per cent of older women, but it can occur at any age.” The less common Hyperthyroidism affects about 1 per cent of people and can also occur across the lifespan but is most common in women between the ages of 20 and 50 years.
So, how can we support our thyroid health?
Research supports the importance of good quality sleep regarding our hormone health. This 2021 study found that both sleep quality and stress levels impact our thyroid health, and the authors point out, “Some studies show that sleeping less than 6 hours a day is associated with disorders of energy metabolism.”
Gamberg says another area we can focus on is the food we eat, ensuring our diet includes foods that are rich in iodine, as it plays a key role in our thyroid health.
- Iodine (seaweed, tuna, eggs and fortified table salts)
- Selenium (Brazil nuts, tuna, sardines, eggs and legumes)
- Zinc (shellfish, beef, chicken and legumes)
- Vitamin B12 (fish, meat, poultry, eggs, and dairy products)
- Iron (meat, fish, eggs, iron-fortified cereals, Leafy green vegetables)
- Vitamin D (fatty fish, egg yolks, mushrooms, and exposing your skin to safe levels of sunshine)
According to the Australian Thyroid Foundation, approximately 50 per cent of pregnant women suffer from iodine deficiency, so Gamberg recommends that pregnant and breastfeeding women take prenatal vitamins containing 250 micrograms of iodine daily. But as Smith points out, for most of us there is no need to supplement our iodine, as too much can actually be toxic.
“Iodine is normal in our diets now,” he says, “it wasn’t always like this, but a normal Australian diet should be enough to take care of your iodine requirements.”