The Tiny Gland with a Giant Role: Understanding Thyroid Health at Every Age

Thyroid 360°: Your Guide to Detecting, Diagnosing & Defeating Disorders

Health News: The thyroid gland, located at the base of the neck, plays a vital role in regulating metabolism through the release of thyroid hormones. When the thyroid produces too little hormone, it’s called hypothyroidism (underactive thyroid), and when it produces too much, it’s called hyperthyroidism (overactive thyroid). Both conditions can affect many body systems and require medical diagnosis and management.  

Thyroid hormones are important for physical and cognitive development in children. Congenital hypothyroidism means a child is born with an underactive or absent thyroid, which can cause irreversible brain damage and stunted growth if not treated quickly. Fortunately, newborn screening programs help detect this early.

In slightly older children and adolescents, thyroid issues can manifest as delayed puberty, growth retardation, weight fluctuations, and academic difficulties. Those at higher risk—especially with a family history or autoimmune disease—should be monitored regularly.

During pregnancy, the demand for thyroid hormones increases. These hormones are vital for the baby’s brain development, especially in the first trimester, when the fetus is entirely dependent on the mother. Both hypothyroidism and hyperthyroidism in pregnancy can lead to miscarriage, premature birth, low birth weight, and complications like preeclampsia. If maternal hypothyroidism is not treated, it can harm the child’s brain and motor development. Women with a personal or family history of thyroid problems, goiter, or autoimmune diseases are advised to get thyroid screening at the beginning of pregnancy.

Thyroid-related problems in adults often present subtly and may be mistaken as normal signs of aging. Symptoms like fatigue, constipation, memory issues, and depression are classic signs of hypothyroidism, yet are often ignored.

In contrast, hyperthyroidism in the elderly can present as a more silent version, known as apathetic hyperthyroidism. Symptoms include unexplained weight loss and palpitations.

Since both hyperactive and underactive thyroids can significantly affect cardiovascular health, regular screening becomes more relevant with age.

Common Thyroid Disorders

• Hypothyroidism (Underactive Thyroid):
  Most common, especially in women. Occurs due to insufficient hormone production. Often caused by Hashimoto’s thyroiditis, an autoimmune disease.
  Symptoms: Fatigue, weight gain, cold intolerance, constipation, dry skin and hair, depression, menstrual irregularities, infertility.

• Hyperthyroidism (Overactive Thyroid):
  Speeds up the body’s metabolism.
  Symptoms: Weight loss despite normal or increased appetite, heat intolerance, excessive sweating, tremors, diarrhea, palpitations, anxiety, restlessness, insomnia, irritability.

• Subacute Thyroiditis:
  Temporary thyroid inflammation, usually post-viral.
  Symptoms: Neck pain, fever, temporary hormonal fluctuations.

• Goiter:
  Visible or palpable enlargement of the thyroid gland. Usually due to iodine deficiency or autoimmune conditions. May cause difficulty swallowing or breathing in some cases.

• Thyroid Cancer:
  Less common but increasingly diagnosed. Often detected suddenly. Most cases have good prognosis with timely surgery and follow-up.
  Symptoms: Persistent neck lump, voice changes, difficulty swallowing, rapid enlargement of swelling.

Important Points

Hypothyroidism (Underactive Thyroid)

• Causes:

  • Autoimmune disease (e.g., Hashimoto’s thyroiditis)

  • Thyroid surgery or radiation

  • Certain medications (e.g., lithium)

  • Congenital thyroid defects

  • Iodine deficiency (rare in the U.S.)

• Symptoms:

  • Fatigue, weight gain, constipation

  • Cold intolerance, dry skin, depression

  • Slow heart rate, memory issues

  • Puffy face, hoarse voice

• Diagnosis:

  • Blood tests: Elevated TSH, low T4

  • Sometimes T3 and antibody tests

• Treatment:

  • Daily thyroid hormone replacement (levothyroxine)

  • Regular monitoring to adjust dosage

• Complications if Untreated:

  • Goiter, heart disease, infertility

  • Myxedema (rare, life-threatening coma)

Hyperthyroidism (Overactive Thyroid)

• Causes:

  • Graves’ disease (most common)

  • Thyroid nodules (toxic goiter)

  • Thyroiditis

  • Excess iodine intake

  • Pituitary adenoma (rare)

• Symptoms:

  • Weight loss despite increased appetite

  • Rapid heartbeat, tremors, anxiety

  • Heat intolerance, insomnia

  • Diarrhea, hair loss, irregular periods

• Diagnosis:

  • Blood tests: Low TSH, high T3/T4

  • Antibody tests (for Graves’)

  • Imaging: Radioactive iodine uptake scan, ultrasound

• Treatment Options:

  • Antithyroid medications (e.g., methimazole, PTU)

  • Radioactive iodine therapy (may cause hypothyroidism)

  • Surgery (partial or full thyroid removal)

  • Beta-blockers for symptom relief

• Complications if Untreated:

• Atrial fibrillation, stroke

• Osteoporosis, thyroid storm (emergency)