Thyroid Problems: Here Are The Warning Signs And How To Check

If you’re a woman, there’s a good chance you spend a lot of time thinking about your breasts. You may have wanted them to be bigger (or smaller) as an adolescent, stressed about your milk supply as you became a mother and started lactating, or entered the stage of life where you need regular mammograms to help protect against breast cancer (which roughly 1 in 8 women in the U.S. will deal with in their lifetime).

But there’s another body part you need to make sure you’re monitoring: your thyroid. Similar to the prevalence of breast cancer among women, the American Thyroid Association says that 1 in 8 women in the U.S. will develop a thyroid disorder, and 60% of those who have one are unaware of their condition.

Here, experts explain why staying on top of your thyroid function is important, and list some red flags that something may be up with yours.

First, it’s good to know what your thyroid does in the body. “The thyroid is a butterfly-shaped gland right near the larynx that produces hormones,” said Naresh Rao, a board-certified family medicine physician, partner at Sports Medicine at Chelsea and founder of Max Sports Health in New York City.

The thyroid’s main function is to produce triiodothyronine (T3) and thyroxine (T4), which help regulate almost all bodily functions, including your weight, metabolism, energy levels and body temperature, as well as how your skin, hair and nails grow.

There’s also something called the thyroid-stimulating hormone, which is produced by the pituitary gland and tells your thyroid to make more T3 and T4. There are tests to check your TSH, T3 and T4 levels, all of which can tell doctors if you have a thyroid problem. (More on that in a minute.)

There are two main reasons you and your doctor might want to start monitoring your thyroid. First, any family history of thyroid conditions, such as thyroid nodules, means you should keep an eye on yours as well. Additionally, it might be wise to do an exam if you’re feeling an array of confusing symptoms where you just can’t pinpoint the exact problem.

“Fatigue, feeling cold or hot all the time, hair loss, sudden weight gain or loss, palpitations, diarrhea, or issues with your menstrual cycle can all signal a thyroid issue,” said Sun Lee, an assistant professor of medicine at Boston University School of Medicine, endocrinologist at Boston Medical Center, and member of the American Thyroid Association. The two main classifications of thyroid problems are hypothyroidism, where the gland is underactive, or hyperthyroidism, where it’s overactive. However, there can be other issues as well.

People often don’t think they have a thyroid issue because the symptoms are thought of as synonymous with aging, said Cheryl Rosenfeld, managing partner of North Jersey Endocrine Consultants in Denville, New Jersey, and a member of the American Association of Clinical Endocrinology.

“Many people pass off fatigue, weakness, loss of memory, dry skin or hair loss as expected effects of getting older,” Rosenfeld said. “However, it is important to rule out thyroid disease as a cause of these symptoms first.”

Both Lee and Rao said there aren’t any recommendations for routine thyroid screenings in cases that don’t involve symptoms or family history, so it’s important to speak to your doctor if any of these confusing red flags have you feeling off. From there, your doctor can do a series of tests in addition to bloodwork.

“Your doctor may start by examining the thyroid with their hands ― this is called palpation,” Rosenfeld said. “They will place their fingers on the bottom of the neck while they are facing or standing behind you. You may be asked to drink water to make the thyroid move, to see if they feel any abnormalities.”

If anything does feel unusual, Rosenfeld said, your doctor may order an ultrasound to check for any potential thyroid nodules or enlargement of the thyroid. They may also order bloodwork to check specific TSH, T3 or T4 levels or thyroid antibodies, which could signal an autoimmune thyroid condition like Hashimoto’s disease.

From there, doctors can get a picture of your thyroid health and determine the next steps to take, or check for a separate issue behind your symptoms, such as anemia or a vitamin D deficiency unrelated to the thyroid.

“It’s important to keep in mind that ― aside from eating a healthy, balanced diet and getting enough exercise ― there is no special thyroid diet you should be doing,” Rosenfeld said.

You can also do self-checks at home using your hands, a mirror and a glass of water, according to the Cleveland Clinic. First, locate your thyroid, which is generally on the front of your neck between your Adam’s apple and collarbone. Then, tip your head back as you look at your reflection.

Finally, as the Cleveland Clinic states: “Take a drink of water while your head is tilted back. Watch your thyroid as you swallow. During this test, you’re looking for lumps or bumps. You may be able to see them when you swallow the water.”

You should repeat this a few times to get a good visual. Here’s a video that shows exactly how to do the at-home process.

As with any organ, your thyroid may start to function differently as you get older.

“Thyroid dysfunction generally occurs in either early adulthood (late 20s to early 30s) or between the ages of 40 to 50,” Lee said. “As we get into our 70s, TSH naturally increases, meaning that your thyroid hormone levels may shift to be a little lower. This seems to happen to protect our bodies as we age, with less stress on our heart and metabolic system.”

This is important to note, Lee said, because it gives physicians a greater threshold to treat someone who is older who may have higher TSH levels. Alternatively, low TSH levels can be more harmful the older we get.

This isn’t to say that if you’re young, you don’t need to think about your thyroid at all. Thyroid disorders can happen at many different ages, as can lumps.

“We do know that the younger population, those in their 20s, 30s and 40s, can develop thyroid nodules,” Rao said. “The vast majority of these nodules, especially if they’re below one centimeter, are 95% of the time completely benign. But it’s still important to be aware that they are there, and periodically monitor them.”