Fatigue, unexplained weight changes, and mood swings. These common complaints can have many causes, but one often-overlooked culprit is the thyroid. This small, butterfly-shaped gland in the lower front of the neck produces hormones that influence every cell, tissue and organ in the body, controlling metabolism, heart rate and how quickly the body processes everything from food to sugar.
“In addition to thyroid dysfunction, there are many factors that can affect our energy levels, weight, and mood such as sleeping and eating patterns, stress levels, medications, and other medical conditions,” said Erin DeLaney, M.D., vice chair for clinical affairs and quality in the UAB Department of Family and Community Medicine. “A comprehensive approach is needed to fully understand and address these types of symptoms. Through a thorough history and physical exam, a primary care physician can determine if and when thyroid testing is needed “
According to the American Thyroid Association, more than 12% of the U.S. population will develop a thyroid condition during their lifetime, yet up to 60% of those with thyroid disease are unaware of their condition. Women are particularly vulnerable, being five to eight times more likely than men to experience thyroid problems.
When symptoms signal a thyroid problem
An estimated 20 million Americans have some form of thyroid disease, and the consequences of leaving it undiagnosed can be serious. Undiagnosed thyroid disease may put patients at risk for cardiovascular diseases, osteoporosis and infertility.
The two primary thyroid disorders produce distinct symptoms. Hypothyroidism occurs when an underactive thyroid does not produce enough thyroid hormone, leading to extreme fatigue, depression, forgetfulness, and weight gain. Hyperthyroidism, or an overactive thyroid, results in irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, and vision problems.
The right tests for accurate diagnosis
“The best initial test to use in diagnosing a thyroid condition is a thyroid-stimulating hormone (TSH) level,” DeLaney said. “If that is out of range, then a serum thyroxine (Free T4) level should be considered. Other tests may be warranted depending on whether these previous levels are high or low.”
This multistep approach ensures patients receive the appropriate testing without unnecessary procedures while providing a clear picture of thyroid function.
Treatment options and what to expect
Once diagnosed, thyroid conditions are highly manageable with proper treatment and medical oversight.
Standard treatment for hypothyroidism is oral levothyroxine, a synthetic T4. While levothyroxine begins to work immediately, full symptom relief can take several months. Treatment for hyperthyroidism includes oral anti-thyroid medications like methimazole or propylthiouracil, radioactive iodine treatment, and even surgery (thyroid gland removal) in certain situations.
DeLaney emphasized the importance of working closely with a primary care physician throughout treatment. “Both under and over treatment have the potential to lead to long-term consequences. While proper treatment can help prevent complications and improve symptom manifestation.”
Patients should keep follow-up appointments for ongoing symptom management, lab surveillance, and medication adjustments, and adhere to their daily medication regimen.
Protecting your long-term health
Left untreated, thyroid conditions can have far-reaching effects on overall health.
“Thyroid conditions, particularly hypothyroidism, affect multiple organ systems through metabolic slowing and hormone deficiencies,” DeLaney said. “When not addressed, there can be cardiovascular effects, insulin resistance, fertility difficulties, mood, and memory trouble among other issues.”
The good news is that with proper diagnosis and treatment, patients can effectively manage their thyroid condition and protect their long-term health.
For those experiencing persistent fatigue, unexplained weight changes, or other concerning symptoms, a conversation with a family physician could be the first step toward feeling better.