The thyroid: your body’s regulator
At the front of your neck, under your voice box, there is a butterfly-shaped organ whose release of hormones affects every part of your body, regulating functions such as your temperature, metabolism, and heartbeat. It is your thyroid gland.
Thyroid glands commonly malfunction, typically by over- or under-producing hormones. More than 12% of the U.S. population—including one in eight women—will experience a thyroid disorder at some point in their lives, according to the American Thyroid Association (ATA).
Yet, thyroid disease often goes undetected. The ATA says that 60% of people don’t know they have it, increasing their risk for cardiovascular diseases, osteoporosis, or infertility.
Thyroid hormones: too many, too few
Sometimes the thyroid gland makes too many hormones. The resulting “hyperthyroidism” can cause weight loss, a pounding heart, sleep trouble, muscle weakness, frequent or loose bowel movements, nervousness, or irritability.
The most common cause of hyperthyroidism in the U.S. is the autoimmune disorder Graves' disease. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) estimates that Graves’ disease affects 1 in 200 people, usually between ages 30 and 50. It is seven to eight times more common in women than men.
Another autoimmune disorder, Hashimoto’s disease, is the main cause of “hypothyroidism,” the underproduction of thyroid hormones. Hashimoto’s is at least 8 times more common in women than men, the NIDDKD says. Overall it affects some 5 out of 100 people, typically aged 40 to 60, with symptoms that may include fatigue, weight gain, depression, constipation, heavy or irregular menstrual periods, or problems becoming pregnant. Endocrinologist Dr. Pooja Narwal says Hashimoto’s is very treatable. “Not all patients need to be on thyroid medication,” she said. Family history increases the risk for both Hashimoto’s and Graves’.
Thyroid nodules are common in women too
Solid or fluid-filled lumps within the thyroid gland are called nodules. Four times as many women as men get thyroid nodules. By age 60, about one-half of all people have one, the ATA says.
Most nodules are not cancerous and don’t produce any symptoms but warrant evaluation. To rule out cancer, your doctor may perform a thyroid ultrasonography or fine needle biopsy, which is a low-risk office-based procedure. “We perform it under sonographic guidance and send the biopsy samples to the lab for reporting,” Dr. Narwal said. Early detection of cancer allows for timely treatment and more positive outcomes, she says. “With sophisticated genetic testing of thyroid nodules, we can prevent many unnecessary thyroid surgeries. Thyroid cancer has an excellent prognosis.”
Thyroid disease and pregnancy
Hyperthyroidism and hypothyroidism can make your periods heavy or irregular or stop them for several months or longer. They can also make getting pregnant difficult. But they need not prevent a healthy pregnancy or good health.