Thyroid Basics: Understanding Hypothyroidism and Hyperthyroidism

Thyroid disorders are among the most common hormone problems in India, and they affect women more often than men. Many people live with an undiagnosed thyroid problem for years because the symptoms develop slowly and can be mistaken for stress or ageing.

What the thyroid does

The thyroid is a small, butterfly-shaped gland at the front of your neck. It makes hormones called T3 and T4, which control your metabolism, meaning how your body uses energy. These hormones affect your heart rate, body temperature, weight, mood, digestion, skin, hair and menstrual cycles.

A gland in the brain called the pituitary releases TSH (thyroid stimulating hormone), which tells the thyroid how much hormone to make.

Hypothyroidism: an underactive thyroid

This is the more common condition in India. The thyroid does not make enough hormone, so body functions slow down.

• Tiredness and sluggishness
• Weight gain without clear reason
• Feeling cold more than others
• Dry skin, hair fall and brittle nails
• Constipation
• Low mood or poor concentration
• Heavy or irregular periods
• Puffiness of the face

Common causes include autoimmune thyroiditis (Hashimoto's), iodine deficiency in some regions, and previous thyroid surgery or treatment.

Hyperthyroidism: an overactive thyroid

Here the thyroid makes too much hormone, and body functions speed up.

• Weight loss despite a good appetite
• Fast or irregular heartbeat
• Feeling hot and sweating more
• Nervousness, irritability or anxiety
• Tremors in the hands
• Frequent bowel movements
• Difficulty sleeping
• Lighter periods

Graves' disease is a common cause, and some people develop swelling of the eyes.

Getting tested

A simple blood test can check your thyroid. TSH is usually the first test. Your doctor may also order T3 and T4 (total or free) and sometimes thyroid antibodies. In general, a high TSH suggests an underactive thyroid and a low TSH suggests an overactive one, but your doctor will interpret the full picture.

Testing is especially useful if you have symptoms, a family history, are planning pregnancy or are pregnant, or have diabetes or other autoimmune conditions.

Treatment

Hypothyroidism is usually treated with a daily thyroid hormone tablet, levothyroxine. Hyperthyroidism may be treated with medicines that reduce hormone production, or sometimes with radioactive iodine or surgery.

Tips if you take thyroid tablets

• Take levothyroxine on an empty stomach, usually first thing in the morning with water
• Wait 30 to 60 minutes before breakfast, tea or coffee
• Keep a gap of about four hours from calcium, iron supplements and antacids, as they can reduce absorption
• Take it at the same time every day
• Do not change the dose or brand without consulting your doctor
• Get your TSH checked as advised, usually every six to twelve weeks after a dose change and then periodically

Thyroid and pregnancy

Thyroid hormone is very important for a baby's brain development. Women with thyroid conditions who are planning pregnancy or are pregnant often need their dose adjusted and more frequent tests.

When to see a doctor

If you notice a swelling in your neck, a racing heart, or several of the symptoms above, please consult a doctor. Thyroid conditions are very manageable once correctly diagnosed and treated.