How Is Thyroid Disease Diagnosed and Treated? (video)

Your thyroid gland produces hormones that affect your metabolism, energy level, body temperature and more. If it produces too much or not enough thyroid hormone — known as an imbalance — you may experience symptoms ranging from barely noticeable to very bothersome.

In this video, San Diego Health host Susan Taylor talks with Matthew Levine, MD, an endocrinologist at Scripps Clinic Anderson Medical Pavilion in La Jolla and Scripps Clinic Carmel Valley, about thyroid hormone problems and how to correct them.

The thyroid is a butterfly-shaped gland in the front of your neck just below the Adam’s apple. Thyroid disease, which causes hormone imbalances, typically results from abnormal thyroid function and becomes more common with age.

Thyroid disease is usually due to an autoimmune condition, which causes a person’s immune system to mistakenly attack their own healthy cells. Hashimoto’s thyroiditis, for example, can disrupt the thyroid gland’s hormone production, while Graves’ disease results in too much hormone. Autoimmune conditions typically run in families and tend to affect women more often than men.

Another cause of thyroid disease is the abnormal growth of nodules in the thyroid gland, which affect hormone production. These too are more common in women, can run in families and increase with age.

Often, nodules are discovered during a physical exam or when a patient has X-rays or imaging tests for other reasons. Doctors diagnose, evaluate and monitor thyroid nodules using ultrasound. Most growths are benign or noncancerous, but about 10% indicate thyroid cancer.

Hypothyroidism, or underactive thyroid, happens when the thyroid gland does not produce enough hormone. It can affect up to about 10% of individuals as they age. Symptoms of underactive thyroid can be vague but often include weight gain, dry skin and feeling fatigued, sluggish, cold or weak. 

Conversely, hyperthyroidism or overactive thyroid occurs when the thyroid gland produces too much hormone. As you might expect, overactive thyroid symptoms can include weight loss, sweating, having a rapid heart rate and feeling jittery or anxious. Hyperthyroidism affects about 5% of people.

In addition, feeling something unusual in your neck beneath the Adam’s apple or having difficulty breathing or swallowing may indicate a growth developing on the thyroid gland.

“The sign and symptoms of thyroid disease can be elusive or nonspecific. Things like fatigue or weakness, for example, can be caused by a whole host of other possibilities,” explains Dr. Levine. “But with that said, if somebody has symptoms emerging over time that are outside of what they would usually feel, that’s a good reason to go see your physician to find out whether they could be related to thyroid disease.”

Thyroid disease can be easily diagnosed by a blood test that measures the amount and type of thyroid hormone in your blood.

Treatment for thyroid disease depends on the cause and severity of the condition. Underactive thyroid is typically treated with thyroid hormone replacement pills, usually needed for life. Overactive thyroid treatment may be more complex.

“Depending on the exact reason for the overactivity, treatment, could also be as simple as a pill that somebody can take daily,” says Dr. Levine. “Or, it can be more definitive, such as a radioactive treatment to knock out or ablate the thyroid or even surgery to remove the thyroid gland.”

If the cause is thyroid cancer, treatment is often surgery to remove part or all of the thyroid gland. Thyroid cancer typically does not require chemotherapy or radiation therapy, and the cure rate is very good.

“Even though the symptoms of thyroid disease can be nonspecific and caused by other possibilities, it is common, easily diagnosed and easily treated,” says Dr. Levine. “So it would be a shame for somebody who is having symptoms to not get evaluated.”